Folic acid supply chain strengthening
UNITED NATIONS CHILDREN'S FUND
Terms of Reference (TOR)
For Institutional Contract for Assessment of Iron Folic Acid Supply Chain for strengthened Pregnant Women Access to IFA Supplementation IN Selected States of Northern Nigeria
1. Background:
There are an estimated 10,223,078 pregnant women in Nigeria. The maternal mortality rate in Nigeria remains unacceptably high, with 814 maternal deaths for every 100,000 live births with considerable disparities existing - North-East Region of Nigeria has the highest maternal mortality rate in the country at 1,549 maternal deaths per 100,000 live births, compared to 165 per 100,000 in the South West. Anaemia in pregnancy is associated with an increased risk of premature delivery, maternal and child mortality, and infectious diseases. The WHO (2011) estimates anaemia in pregnant women in Nigeria at 58%.
The most significant contributor to the maternal deaths is iron deficiency. As low as 20.5% of pregnant women consumed at least 90 Iron Folic Acid (IFA) tablets. Providing IFA supplementation in Nigeria will contribute to reverse the trend whiles feeding into UNICEF global, regional and country results. Evidence shows that there is a 70% reduction in the risk of developing iron deficiency anaemia when pregnant women receive daily supplementation of iron. The WHO (2016) recommends daily iron-folic acid (IFA) supplementation beginning as early as possible in pregnancy with a dose composition of 30-60mg of elemental iron and 0.4mg of folic acid in all settings; however, in settings where the prevalence of anaemia is severe (i.e. >40%), a daily dose of 60mg of elemental iron is recommended.
Globally, UNICEF advocates to government and implementing civil society partners for IFA supplementation during pregnancy and supports them to scale up this intervention. As part of the Nigeria Country Office programme, Maternal nutrition has been identified as a priority intervention to reduce maternal deaths and prevent stunting in the country. This is done largely through Iron Folic Acid (IFA) supplementation and working with both the Federal and State governments to strengthen policy and guidance on micronutrient deficiency control, including maternal micronutrient supplementation. By providing technical support and guidance to stakeholders at state and Federal level, UNICEF ensures programs are effectively monitored and data made available for evidence-based decision making to support maternal nutrition. UNICEF is currently working with the Federal and State governments to implement iron-folic acid supplementation programme for pregnant women in selected states.
In 2018, UNICEF received funding support from Nutrition International to further scale up the iron folic acid supplementation in four states of Northern Nigeria. With the initiative, UNICEF will improve the IFA supplementation in the states, Katsina, Kebbi, Sokoto and Zamfara. The project will specifically focus on improving the availability of sufficient and quality IFA for pregnant women in government health facilities, increasing the uptake of IFA among pregnant women and promoting the alignment of Nigerian national and state-level policies/strategies with international guidelines on IFA.
In addition to inadequate IFA supplements for programme scale up, there are concerns of shortages of the supplies at the facility level even when available at state warehouses. This is a threat to ensuring end users (pregnant women) received the needed supplementation to reduce anaemia during pregnancy. Strong and efficient supply chains are the essential to deliver these essential supplies for women. There is a need for strengthening government capacity to ensure the effective and timely implementation of micronutrient deficiency control interventions and a smooth functioning of downstream supplies pipeline.
Purpose of Assignment:
The purpose of the assignment is to assess the supply chain of Iron-folic acid to identify barriers and facilitators to good
supply management and identify corrective actions where needed. The institution will work with stakeholders to identify the key barriers and challenges to optimal supply management within the IFA programme, and recommend strategies to strengthen the supply network, with specific focus on the last mile.
5. Major Tasks to be accomplished: (Estimated time required to complete tasks. Attach additional sheets, if necessary, to describe assignment
Task
Tentative time frame
6.1 To assess the key components of the supply chain, with the aim of understanding the barriers and facilitating factors of IFA supplements for pregnant women in six states of Northern Nigeria.
2 week
6.2 Review available past assessments conducted by government or other stakeholders;
1 week
6.3 Identify enablers and bottlenecks affecting smooth delivery of the product at the various level.
3 days
6.4 Scan the local market structure as relating to cost structures, formulations, specifications, availability of the commodities and local capacity for manufacturing/importation.
2 weeks
6.5 Identify roles of the partners and institutions in IFA commodity supply chain such as relevant government and state departments, facilities and partners;
NB. Some of the tasks will run concurrently and must be completed within the agreed timeline of the assignment
Deliverable
Description
Time frame / frequency
Detailed work plan of the assignment
Workplan to be developed at inception with detailed timelines, activities to carried out and outline/format of the assessment report. This should be agreed with UNICEF focal point
Two days after the contract is signed (December, 20th, 2018 - tentative )
Draft IFA supply chain assessment report
Standard report with content including the methodology, findings, conclusions, recommendations and annexes as may be appropriate.
December 22nd, 2018 (tentative)
Final comprehensive assessment Report.
This is the final and main product of the assignment. It will include the draft report (deliverable 2), ensuring inputs, comments and other feedback from the draft report provided by UNICEF and/or its agents are incorporated into it.
December 28th, 2018 (tentative)
Schematic delivery chain map
A diagram showing clearly which partners provide IFA, distribution channel, types of conditionality (if any) established for accessing the commodities at peripheral level and if the conditionality are adhered to.
December 28, 2018 (tentative)
End of assignment report
Elaborate the achievements of the work-plan (refer to deliverable 1) and any other information as may be useful to UNICEF.
January, 29th, 2019 (tentative)
Lists and contact addresses of stakeholder organizations, including the private sector visited and/or interacted with.
Comprehensive lists of stakeholders interacted with, including organizations’ contact addresses and telephone numbers. Could be consider as an annex to the assessment report.
December 28th, 2018
4 days
6.6 Assess availability and accessibility of the IFA commodities by targeted clients at different level of health facilities. This includes also sales, donations.
1 week
6.7 Based on the assessment, recommend practical ways to address challenges of the IFA supplies chain.
3 days
The concepts, outputs and products generated from this assignment will be intellectual property of UNICEF and the organisation shall seek and request prior approval before sharing them to other organisations or for use.
5. Qualifications or specialized knowledge/experience required:
Ø Experience in conducting assessment of commodities value chain and/or utilization. Similar task including engaging private sector stakeholders in nutrition.
Ø Knowledge of health/nutrition commodities/supplies handling.
Ø Professional experience and/background in auditing of goods and services.
Willingness to comply with UNICEF Harmonised Approach to Cash Transfer (HACT) approaches such as micro-assessments, spot-checks including at end-user level.
5. Technical Evaluation Criteria and relative points
Technical Criteria
Technical Sub-criteria to evaluate
Maximum Points
Overall Response
Completeness of response
Overall concord between RFP requirements and proposal 10%
Company and Key Personnel
Range and depth of experience with similar projects;
Key personnel: relevant experience and qualifications 10
Proposed Methodology and Approach
Technologies/approaches used - compatibility with UNICEF approaches including HACT.
Project management, monitoring and quality assurance process
Innovative approaches 40%
Maximum Points
70
Total Maximum
49/70
Only proposal that scored the minimum cut off mark will be considered for the next stage of the process (financial offer evaluation)
Duration : This consultancy is expected to take place over six weeks from date contract is signed
Payment : shall be in instalment of four maximum times tied to deliverables