TERMS OF REFERENCE

Review and Development of Adolescent Nutrition Training Manuals and Guidelines to Conduct Teachers Training on the Implementation of Comprehensive Adolescent Health and Nutrition Education in Schools

1. About Nutrition International.

Nutrition International is a global organization, which aims to transform the lives of people, especially women, adolescent girls, and children, by improving their nutritional status and health, as these groups often have the greatest unmet needs. Nutrition International envisions a world where everyone, everywhere is free from malnutrition and able to reach their full potential. Nutrition International believes that good nutrition and gender equity are mutually reinforcing; improving nutrition is critical to achieving gender equity, and in turn improving gender equity leads to improved nutrition. Access to good nutrition is a universal human right and the potential to transform is closely linked to overcoming gender inequalities.

1. Background and Justification.

Adolescence is a transformative life phase, with the growth and maturation of all organs and physiological systems occurring between the age of 10-19 years. The impact of adolescent health and nutrition status later in adulthood and the potential effects on future offspring are profound—especially for adolescent girls. Greater nutrition and health advocacy efforts are needed for this demographic for a variety of reasons. Health, nutrition and associated risks and vulnerabilities are primary factors, as well as the general notion that adolescents require fewer healthcare services. Parental and caregiver neglect is also a factor. World Health Assembly (WHA) Resolution 65.6 targets provide a critical impetus for action on adolescent health and nutrition. In Tanzania, adolescents are a key segment of the population accounting for about a fourth of the country’s population (Tanzania Demographic and Health Survey (TDHS), 2022). Adolescents in Tanzania face a triple burden of malnutrition with underweight, overweight and obesity and micronutrient deficiencies. The most recent national health and demographic survey shows that prevalence of thinness among adolescents aged 15-19 years is 41% among boys and 18% among girls. In addition, 2.8% of boys and 9.9% of adolescent girls aged 15-19 years are overweight and 0.4% of boys and 2.3% of girls are obese. The prevalence of anaemia among adolescent girls 15-19 years is 39.5% (TDHS 2022) and is a public health concern according to WHO guidelines.  An estimated 30% of adolescent girls in Africa are affected by anaemia, with approximately half of those cases being related to iron deficiency. Iron-deficiency anaemia impacts adolescent physical wellbeing and cognitive functioning, compromises school performance, reduces productivity and affects current and future reproductive health.

Nutrition International is part of a consortium of partners implementing Realizing Gender Equality, Attitudinal Change & Transformative Systems in Nutrition (REACTS-IN) project in Simiyu region. Under the REACTS-IN project, Nutrition International will work with partners to implement evidence-based nutrition interventions, as well as consider and where possible deliver nutrition sensitive activities that will address the key determinants of nutrition, gender inequalities and sexual and reproductive health in underserved and rural target areas.

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3. Background and Rationale for development of Teachers nutrition training packages   

REACTS-IN’s ultimate outcome will be achieved through three intermediate outcomes: ensuring Women and Adolescent Girls (WAGs) have equitable access to nutrition, health, Water Sanitation and Hygiene(WASH) and Sexual and Reproductive Health and Rights(SRHR) practices, enhanced availability, and quality of gender-equitable and responsive nutrition, health and Sexual and Reproductive Health (SRH) services, and through strengthening the effectiveness of local stakeholders including rights groups in realizing the nutrition and SRH rights of WAGs.

In Simiyu region, adolescent anaemia prevalence rate is 50.8% (SMNS, 2019), surpassing the national average of 34.1%. In addition, the region also has high rates of adolescent pregnancies, with over 25% of adolescent girls 15-19 years having begun childbearing.

To address adolescent nutrition challenges in Tanzania, through the REACTS-IN project, Nutrition International will focus on creating enabling environment for provision of gender equitable nutrition education using the school platform for both girls and boys. One of REACTS-IN’ activities includes developing comprehensive teachers’ training package on adolescent nutrition, which will inform the adolescent nutrition education provision at school. The package will include a teaching guide and a sensitization package for school committees and community health workers. This training package will also inform the Behavior Change Intervention strategy and messages for improvement of adolescent nutrition and reduction of anemia.

Nutrition International therefore seeks to contract a consultant who will conduct a thorough review of current existing teachers’ nutrition training package and guidelines on adolescent nutrition to improve quality of adolescent nutrition education provision in schools.

Objectives of Consultancy 

1. Conduct a desk review of current existing nutrition training manuals and facilitator guidelines for adolescent nutrition.
2. Develop a teacher’s training package on adolescent nutrition
3. Develop the Training of Trainers (ToT) guide to ensure inclusion of all critical nutrition content for adolescents.

Scope of Work of the Consultancy   

The consultancy team/consultant is expected to undertake the following tasks and responsibilities:   1. Develop Workplan

1. Develop a detailed plan that clearly outlines key steps and timelines for completion of deliverables as outlined in this Terms of Reference (ToR)
2. Desk Review
3. Outline the framework and methodology for the desk review
4. Review existing nutrition guidelines, nutrition policies, nutrition training manuals/ modules and nutrition interventions under Tanzania Food and Nutrition Center (TFNC), Ministry of Health (MOH). Ministry of Education (MOE) and World  Health Organization (WHO)
5. Identify critical gaps in nutrition content specifically related to Adolescent Nutrition.
6. Conduct stakeholder consultations on current guidelines for teachers’ training on adolescent health and nutrition, with representatives from TFNC, MOH, President’ s Office- Regional Administration and Local Governments (PO-RALG), MOE, MOCD, and relevant United Nation agencies.
7. Present findings at stakeholders’ consultative workshop and incorporate feedback received
8. Develop recommendations for the development of the teacher’s nutrition training package
9. Produce Desk Review Report
10. Desk review report should include at a minimum the following sections: 1. Background and rationale; 2. Objectives; 3. Design and methodology; 4. Key findings; 5. Recommendations for key messages/content areas on adolescent health and nutrition to be provided in school 6. Challenges and lessons learned of the process. It should encompass the results from the desk review and from the stakeholder consultations.
11. Develop ToT package
12. Develop a five-day ToT, package including harmonized adolescent health and nutrition training manual for ToT participants, a facilitator’s guide on adolescent health and nutrition to be used by teachers in schools, and checklist and tools for the implementation of comprehensive adolescent health and nutrition education provision at schools.
13. Present the ToT package at a stakeholder review and validation meeting and incorporate feedback received
14. Pretest tools and checklists to be used for on-the-job capacity building during review meetings and supervision visits, with the inclusion of feedback from the trainer of trainers for any necessary adjustments.
15. Develop a detailed evaluation of the modules to facilitate participant feedback on the training and materials for improvement.
16. Conduct Training of Trainers Training
17. Consultant/ agency will organize and conduct five days ToT, which will include government officials from project areas and consortium partners.
18. Consultant will have clear monitoring tools (checklist, tools and materials) to assist post training follow-up and subsequent trainings of the teachers by those who received ToT.

Nutrition International’s role

Nutrition International’s REACTS IN Technical Advisor, REACTS IN Senior Project Officer and other staff will provide the required support and guidance to the consultant/agency for completing this assignment, including but not limited to draft workplan, stakeholder mapping, and stakeholder consultation interview guide.

Deliverables 

The following deliverables will be required to be submitted in electronic and hard copies to Nutrition International:

1. Final workplan, with revisions based on inputs from NI staff
2. Conceptual framework and methodology to be used to conduct the desk review, including list of organizational websites to be searched for relevant document
3. Master list (excel file) of all relevant documents identified for inclusion in the desk review
4. Final stakeholder mapping and interview guide for stakeholder consultations, plus detailed notes from individual discussions/interviews with stakeholders
5. Minutes and key recommendations from stakeholders’ consultative workshop to share findings of the desk review.
6. Final desk review report incorporating feedback from the stakeholders’ consultative workshop
7. Final ToT package which incorporates feedback from stakeholders’ validation meeting, and includes: t adolescent health and nutrition training manual for ToT participants, a facilitator’s guide on adolescent health and nutrition to be used by teachers in schools, a detailed evaluation plan of the modules covered, checklists and tools for the implementation of comprehensive adolescent health and nutrition education, checklist/tools for monitoring the training quality and pretesting those checklists, tools and materials
8. Conduct ToT, plus a report of the training, with results from pre- and post – training questionnaires administered to participants
9. Detailed financial report, including budget breakdown for each activity and deliverable.

Timeline of Deliverables (monthly basis)   

The following is the proposed time in which the activity is expected to be completed.

Required Expertise   

For this assignment, the consultant or consultancy firm should have the following:

1. Agency/Consultant with at least 5-7 years of experience in conducting similar assignments including desk review and developing nutrition training manual, facilitator guidelines and training materials, conducting ToT as per requirement, preferably for nutrition and health programs.
2. Agency/Consultant should also have post-graduate or equivalent qualification/ degree in Public Health, Nutrition, or other related disciplines.

• Expertise in the development of nutrition guidelines, conducting nutrition specific ToTs and development of post-training follow-up plans.

1. Extensive familiarity with Tanzania education and health system and understanding of services relating to adolescent nutrition and health care.
2. Experience in providing consulting services and excellent track record of completion of tasks according to timelines.
3. Agency/Consultant should have excellent reporting and writing skills in English and Swahili.

Guidelines for Submission 

Interested consultants should submit the following by email to [email protected] by December 13, 2024, close of business:

• Capacity of firm/ CVs: not exceeding 5 pages and qualification of the consultant team
• Technical proposal: not exceeding five pages, describing understanding of the task, proposed methodology, responsibilities of key stakeholders and draft work plan that breaks down activities, outputs and associated timelines.
• Financial proposal: including daily fee rate, total number of days broken down by activity, and any other expenses required to fulfill the terms of the consultancy (field trips, meetings, materials, etc.).

Submissions without Technical and Financial proposals will not be reviewed.

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