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Request for Proposal (RFP) for partnership on the "Improving Diarrhea Treatment Outcome in Northern Nigeria" project

Nutrition international (NI) invites proposals for the purpose of "Improving Diarrhea Treatment Outcome in Northern Nigeria" from reputable non-governmental organizations.

About Nutrition International

Nutrition International (NI) is a global organization dedicated to delivering proven nutrition interventions to those who need them most. Working in partnership with countries, donors and implementers, our experts conduct cutting-edge nutrition research, support critical policy formulation, and integrate nutrition into broader development agenda. In more than 60 countries, primarily in Asia and Africa, NI nourishes people to nourish lives.

Background

Childhood diarrhoea remains a threat to child survival in Nigeria; 10% of deaths in children under five are due to this disease. The country still records national prevalence as high as 13%. State specific variations in prevalence of diarrhoea are also recognised; the prevalence in the north-western states is considerably higher at 20.7% in Kano, 37% in Sokoto,18.6% in Katsina, and 21.7% in Zamfara.
Diarrhoea is a recognised cause of poor nutrition among children particularly in more serious and prolonged cases, due to loss or reduced intake of nutrients associated with episodes of diarrhoea.

Conversely, pre-existing malnutrition is known to prolong episodes of diarrhoea and increase mortality due to childhood diarrhoea. These, and many other undesirable consequences make it vital to integrate diarrhoea management into comprehensive nutrition programming for under five children.

Therefore, Nutrition International seeks to contribute to reducing the number of deaths due to diarrhoea among children under five In Nigeria. Nutrition International will work with implementing partners to provide both technical and financial support to Kano and Sokoto to address key factors associated with increased diarrhoea morbidity and mortality.

Specifically, Nutrition International’s project will support these states to promote prompt care- seeking behaviors among caregivers of children with diarrhoea as well as adherence to standard treatment (zinc and low-osmolarity oral rehydration solution [LO-ORS]). Project states will receive targeted technical and financial support to improve the capacity (knowledge, skill and attitude) of health care providers to implement quality Zinc and LO-ORS interventions and appropriate interpersonal communications for the treatment of all diarrhoea cases seen at health facility or community level service points.

In addition, NI will work to improve the commitment of state actors, such as health managers and policy makers, to implement complementary drug revolving fund (DRF) schemes for effective availability and sustainability of health commodities, including Zinc and LO-ORS.

NI through implementing partners earlier updated the IFA and Zinc Lo ORS Behaviour Change Intervention (BCI) strategy that had been developed in 2017. This was achieved through a desk review of literature on existing SBC materials to explore the knowledge, attitudes and practices of care givers and their influencers with respect to Zinc supplements and LO-ORS for the treatment of childhood diarrhoea. Knowledge and practices of healthcare workers on nutrition counselling were also reviewed.

The qualitative inquiry study based on project specific information was conducted to further inform the BCI strategy. This explored care givers care seeking behaviors, channels of communications, and their experiences in accessing health services including Zinc and Lo-ORS supplies. Other themes such as cultural and social norms, gender barriers, knowledge, attitude and practices of community health workers and community volunteers were also explored.

Nutrition International’s approach to addressing the aforementioned problems is holistic and integrative. Hence it aims to support the target States to better manage diarrhoeal diseases in under-five children, by improving the provision of appropriate information to caregivers and influencers, developing the capacity of and improving the supportive supervision for health workers, and supporting the states to increase and sustain availability and access to Zinc and LO-ORS commodities via support to strengthening their DRF schemes.

Project Scope

NI’s Zinc Lo-ORS project titled “Improve Childhood Diarrhoea treatment outcome in Northern Nigeria”, aims to improve care seeking behavior for diarrhoea and quality of diarrhoea treatment, as a strategy to enhance child nutrition and survival in the states. The overall goal of the project is to contribute to reducing mortality due to diarrhoea in under-five children

Goals and Objectives: The aim of the project is to increase the proportion of children with diarrhoea who receive Zinc and LO-ORS treatment (improve coverage). This is expected.

To ultimately lead to reduced number of children dying from diarrhoea diseases.
To improve the capacity of public health workers by promoting and supporting the use of zinc and LO-ORS combination as first line of treatment for every case of diarrhoea seen at health facilities and community service points
To improve the availability of zinc and LO-ORS in public health facilities by providing support to the states to strengthen the drug revolving fund (DRF) scheme and to advocate for inclusion of zinc and Lo-ORS in the DRF lists in the supported states.
Increase prompt care seeking for children with diarrhoea by their caregivers.

Specific Objectives

To provide zinc and LO-ORS to at least 80% of health facilities using the DRF scheme.
To increase zinc/LO-ORS coverage and childhood diarrhoea treatment with zinc/LO- ORS across the two states.
To increase the number of caregivers who seek care promptly for children with diarrhoea.

Scope of Work

The implementation of the child health and survival improve childhood diarrhea treatment outcome in Northern Nigeria will be conducted in Two states- Sokoto and Kano
The project will focus on 3 key areas, as follows:

i. Improving quality of care: Improving the capacity (knowledge and skills) and motivation of frontline health workers to provide quality care (treatment, counselling and support) to children with diarrhoea and their care givers. This will be accomplished through targeted training, supportive supervision and increasing access to needed commodities.

ii. Improving supply of Lo-ORS and zinc to health facilities to improve availability of the commodities in a sustainable manner. NI will focus on improving state procurement systems for the commodities and support the states to implement or strengthen Drug Revolving Fund (DRF) scheme that incorporate L-ORS and zinc to complement existing health commodity procurement system in the state. The project plans to strengthen the capacity of the state SPHCDA and other line managers at different levels to be able to manage the DRF scheme.

iii. Increasing care seeking for children with diarrhea by their care givers.

Expected Outputs, Activities, and Deliverables.

Expected outputs, activities and deliverables for the project vary slightly between the two target states. Thus, the outputs, activities and deliverables for the project have been outlined by states for the third year of the project.

i. Output: Conduct Meetings with State Policy makers to increase financial commitment for zinc and LO-ORS supply within the DRF scheme in the state.

Activities:

Provide technical and financial assistance to Sokoto and Kano SPHCDA state managers to conduct advocacy meetings with key policy makers and legislators on increasing financial commitment and prompt release to ensure sustained availability of zinc and LO-ORS within the DRF scheme in the state.

Deliverables:

Minutes of advocacy meeting including agreed action points among attendees
Attendance from advocacy meeting

ii. Output: Work with the State Primary Healthcare Management Board and State Drug Consumption Supply Chain Management Agency (DSCMA) to ensure support on the DRF scheme operation with states, DRF committee establishment, capacity building of staffs, and strengthen M&E systems.

Activities:

Conduct training of state pharmacist and pharmacy technicians on DRF operations in Kano
Orientation of LGA DRF committee across LGAs in Kano & Sokoto
Conduct readiness and risk assessment on State DRF Last Mile Distribution (LMD) and transportation system to evaluate existing capacity with the Sokoto states.
Organise a 1-day stakeholders sensitization workshop on the need of private/public sector participation unit within DRF scheme in Kano state.

Deliverables:

Report of trainings at all levels (State, LGA and Ward) including pre/post test scores, photo coverage
Report of workshop/meetings/training
List of participants trained (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker.
Copy of training manual/guides on DRF operation
Readiness and risk assessment on state LMD reports

iii. Output: Workshops conducted with state health managers to develop management plans and tools to strengthen the DRF at state, LGA, and PHC facility levels

Activities:

Provide TA and FA support workshop with stakeholders to develop and implement commodities upgraded plans for all warehouses from the warehouse assessment reports to ensure all warehouses for health commodities are functional and utilized in line with Sokoto state priorities and strategies.
Provide financial and technical assistance to organize workshop with stakeholders to strengthen integration of public health, BHCPF, IMPACT and DRF essential medicines at the health facility level in Sokoto state.
Printing copies of the strengthening plan, SoP, guidelines and tools in 2 states (State sustainable health commodities supply guidelines)
Organise and provide FA to support quarterly State Product Supply Chain Committee review meeting in Kano and Sokoto states.

Deliverables:

Report of workshop/meetings
Report of Review meeting
List of participants (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker/managers.
Soft Copies of tools printed.

iv. Output: Learning conducted by managers and decision makers in project states to one state with high performing DRF scheme.

Activities:

Provide TA and FA support for workshop to review of Sustainable Health Commodity Supply System guideline in Kano state.
Participate in 2-days biannual National/state level cross learning and benchmarking session to review DRF scheme progress, Kano and Sokoto

Deliverables:

Report of workshop/meetings
List of participants (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker/managers.

Output: SPHCDA Team (Health committee & Appropriate authority) in Kano and Sokoto improve DRF Scheme and Logistic Management Information System (MIS)operation via regular monitoring and supervision.

Activities:

Provide TA and FA to support 2- day training of In-State Team member (ISTs) for technical supportive supervision of the DRF HFs for Kano and Sokoto states
Provide TA and FA Support to the DRF states on training on Drugs Quantification for the DRF Scheme (training/Workshop) for Kano and Sokoto states.
Provide TA and FA support for printing of DRF management tools for both states (Kano and Sokoto state)
Annual state DRF performance review meeting with health and supply agencies

Deliverables:

Report of training
Report of workshop/meeting
List of participants trained (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker/managers.
Soft copy of DRF management tools printed

v. Output: Work with the states DRF HFs in Kano & Sokoto state to ensure availability of zinc and LO-ORS using DRF scheme

Activities:

Provide FA to Sokoto state to conduct post Last mile distribution (LMD) of public health and DRF commodity review meeting to validate Prove of delivery (POD) processes and stock reconciliation.

Deliverables:

Report of workshop/meeting
List of participants (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker/managers.

vi. Output: Work closely with the State and LGA SPHCDA teams, NI and Partners to implement regular and effective monitoring and supportive supervision at the health facilities

Activities:

Printing and dissemination of Supportive supervision guidelines and tools to HFs for Kano and Sokoto states
Conduct quarterly joint supportive supervisory visits to DRF visits to health facilities and community service delivery points in Kano and Sokoto states.
NI/State biannual planning and review meeting at state level
Health care providers are trained on, received tools and SMS on good practices for childhood diarrhea treatment and management using zinc and LO-ORS in Kano and Sokoto
Provide TA to SPHCDA in Kano and Sokoto to print and disseminate quick reference guide to all HFs.
Dissemination of good practices for childhood diarrhea treatment and management information to health workers via SMS
Scale up on Training of Health Workers on Integrated Management of Childhood Illness (IMCI) in kano and Sokoto state.

Deliverables:

Report of trainings at all levels (State, LGA and Ward) including pre/post test scores, photo coveragee
Report of workshop/meetings
List of participants trained (including telephone numbers and emails) disaggregated by gender, levels, and cadre of health worker.
Soft copies of all management and SOP tools developed/reviewed and printed.
Reports on supportive supervision and monitoring activities.
Detailed monitoring and reporting plan.
Detailed list of Health workers
Soft copies of consent forms from all media documentation

Submitting the Proposal

The implementing partner is expected to submit to NI a 9-month implementation proposal (ideally not more than ten pages – excluding Annexes, team members’ resumes, previous reports, description of roles, timeline, and the financial proposal), which should have the following outline:

a) A Technical implementation plan (max 10 Pages) detailing:

Rationale and Context for the work to be carried out under the project.
The project’s Overall and Specific Objectives. Describe the proposed approach to zinc and Lo-ORS intervention including a workplan with activities and timeframe, monitoring and reporting.

b) Qualifications of the key personnel of the team. This shall include:

Resumes of each of the key team members (up to 3 pages per resume) with:
Qualifications in public health and nutrition
Relevant social marketing and gender experience
Track records of previous work
Contacts for references A description of roles and responsibilities of each of the team members (up to 2 pages)

c) Plan with a timeline for the objectives and activities: Timeline, which includes specific deadlines for each of the implementation activities, milestones, and deliverables.

d) Financial Proposal (up to 2 pages): Submit a Financial Proposal with a narrative for your budget on a separate sheet. Your budget should include the following details:

Breakup of all activities, outputs, and deliverables.
Estimated cost disaggregated by the number of days each of the team members will be working.
Dates when separate financial reports will be submitted and when payment will be expected.
All amounts need to be quoted in Nigerian Naira.
Fees should be inclusive of all insurance, tax, and standard business overheads.

e) Budget Cap: