Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days

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1 Request for Proposals No: 1663-XX & 1664-XX Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days Issued by the Nutrition International NI (formerly known as the Micronutrient Initiative) Deadline for receipt of proposals at NI: Friday, July 21, 2017 Page 1 of 31

2 Contents Section 1 1. RFP Notice Introduction to the RFP General instructions and considerations General Disclosures Submission of Proposals Receipt, evaluation and handling of proposals Selection criteria Guidelines for preparing Proposals... 6 Part 1: Covering Letter and Declaration... 6 Part 2: General and Technical Proposal... 7 Part 3: Financial Proposal... 8 Anneure 1:Terms of Reference... 9 Anneure 2: Budget Template Page 2 of 31

3 1. RFP NOTICE 1.1. Request for Proposals Procurement Notice Nutrition International (NI), a non-profit agency dedicated to eliminating vitamin and mineral deficiencies worldwide, invites proposals from competent agencies to perform the role of implementing agency for the project Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days in collaboration with the Philippines Department of Health. The submission deadline for proposals is Friday, July 21, INTRODUCTION TO THE RFP 2.1. Nutrition International (NI) is an Ottawa-based, international not-for-profit organization dedicated to ensuring that the world's most vulnerable people, especially women and children in developing countries get the vitamins and minerals they need to survive and thrive. Working with impacted families, communities and nations, we are improving lives of close to 500 million people in more than 70 countries across Asia, Africa and Latin America. NI is supported by the Global Affairs Canada (GAC), Government of Canada and other generous donors. In the Philippines, NI is working with the Department of Health to help address the challenge of malnutrition. NI Philippines program will help inform government policy and national health guidelines to make vitamin and mineral supplementation programs increasingly effective and inclusive. NI will also work with local government units to strengthen nutrition programs for the vulnerable especially pregnant women, infants and young children This Request for Proposals (RFP) and particularly the Guidelines for Preparing Proposals that follow, are designed to help Respondents to produce proposals that are acceptable to NI and to ensure that all proposals are given equal consideration. It is essential, therefore, that Respondents provide the complete information that is requested, and in the formats and on the terms specified. 3. GENERAL INSTRUCTIONS AND CONSIDERATIONS 3.1. These instructions should be read in conjunction with information contained in the enclosed Terms of Reference (TOR), and in any accompanying documents within this package This Request for Proposals (RFP) to provide NI with relevant information for the implementing agency for the project Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days in collaboration with the Philippines Department of Health NI is not bound to accept the lowest priced, or any, proposal. NI reserves the right to request any (or all) Respondent(s) to meet with NI to clarify their proposal(s) without commitment, and to publish on its website answers to any questions raised by any Respondent (without identifying that Respondent) Respondents are responsible for all costs associated with proposal preparation. Page 3 of 31

4 4. CONFLICT OF INTEREST 4.1. Respondents must disclose in their proposal details of any circumstances, including personal, financial and business activities that will, or might, give rise to a conflict of interest. This disclosure must etend to all personnel proposed to undertake the work Where Respondents identify any potential conflicts they must state how they intend to avoid any impact arising from such conflicts. NI reserves the right to reject any proposals which, in NI s opinion, give rise, or could potentially give rise to, a conflict of interest With respect to this condition, please be advised that the organizations that may fall within the scope of this evaluation will include those below, with which any association must be disclosed: a) Nutrition International (NI) b) the Donor who is the primary funding source for the procurement 5. GENERAL DISCLOSURES 5.1. Respondents must disclose: If they are or have been the subject of any proceedings or other arrangements relating to bankruptcy, insolvency or the financial standing of the Respondent including but not limited to the appointment of any officer such as a receiver in relation to the Respondent personal or business matters or an arrangement with creditors or of any other similar proceedings If they have been convicted of, or are the subject of any proceedings, relating to: a) criminal offence or other offence, a serious offence involving the activities of a criminal organization or found by any regulator or professional body to have committed professional misconduct. b) corruption including the offer or receipt of any inducement of any kind in relation to obtaining any contract, with the NI, or any other contracting body or authority c) failure to fulfil any obligations in any jurisdiction relating to the payment of taes 6. SUBMISSION OF PROPOSALS 6.1. The technical and financial proposal along with all requisite documentation must be received in English at NI no later than Friday, July 21, The Technical and Financial Proposal in two separate files put into a covering specifically indicating the subject line Proposal on implementing partner for the Project: Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days and should be sent by to: Lbroquero@micronutrient.org For any clarification required, please write an to Dr. Loreto B. Roquero Jr. at address: Lbroquero@micronutrient.org Page 4 of 31

5 6.3. Only bids will be accepted. Only those short-listed will receive an acknowledgment and will be called for a personal interaction, at their own cost. The interaction will be held at the Micronutrient Initiative office in Manila Late proposals will not be accepted in any circumstances. Proposals received after the due date and time will not be considered. 7. RECEIPT, EVALUATION AND HANDLING OF PROPOSALS 7.1. Once a proposal is received before the due date and time, NI will: Log the receipt of the proposal and record the business information Review all proposals and disqualify any non-responsive ones (that fail to meet the terms set out in these instructions), and retain the business details on file with a note indicating disqualification Evaluate all responsive proposals objectively in line with the criteria specified below Inform respondents within 15 business days of the evaluation decision being made NI reserves the right: To accept or reject any and all proposals and/or to annul the RFP process prior to award, without thereby incurring any liability to the affected Respondents or any obligation to inform the affected respondents of the grounds for NI's actions prior to contract award, and To negotiate - with Respondent(s) invited to negotiate - the proposed technical approach and methodology, and the proposed price based on the Respondent s proposals Amend this RFP at any time 8. SELECTION CRITERIA 8.1. Following criteria will be adopted to short list the proposals and identify suitable agencies for the assignment. Out of the total scores 60% weight is assigned to technical and 40% to the financial proposal. Scoring of Proposals: Selection of Technical Agency/NGO Assessment Category: Technical Proposal Weights Qualification of Firm (A) NGO or Agency's previous eperience of implementing nutrition and health programs for pregnant women, infants and young children, working with the Department of Health, local government units and other partners 50% Availability of adequate and skilled (education and work eperience) team members for carrying out the assignment 30% Clear monitoring, supervision and technical assistance plan 20% Total Score - Technical Proposal 100% Overall weightage Technical 60% Page 5 of 31

6 Assessment Category: Financial Proposal Takes into consideration all potential epenses (i.e. no obvious omissions) 30% Reasonable estimates for development of local policies and nutrition action plans, orientation/capacity building for community health workers, conduct of nutrition education and counseling activities, and client tracking for uptake of services 45% Reasonable estimate for NGO or Agency administrative costs 25% Total Score - Financial Proposal 100% Overall weightage Financial 40% Total Weighted Score (Technical Financial) 8.2. The Evaluation Team may, in its sole discretion, establish a short-list of Respondents based on the Technical Scores of the Respondents (the Short-listed Respondents ) for the purpose of conducting interviews. If NI short-lists the Respondents, it will short-list the Respondents with the highest scores Only the Short-listed Respondents will be interviewed. The number of Respondents short-listed for an interview is in the sole discretion of NI Interviews of Short-listed Respondents will be carried out by the Evaluation Team or a sub-group of the Evaluation Team. The Evaluation Team will score each Short-listed Respondent based on the quality of the Respondent s interview (the Interview Score ) The successful Respondent will be epected to enter into a Contract with NI for the duration of the work. In the event of a Contract award, all the terms and conditions of the RFP, including the Respondent s response, will normally form part of the Contract. 9. GUIDELINES FOR PREPARING PROPOSALS 9.1. Language: Proposals must be submitted in English Structure: Proposals must be set out in three main parts: Part 1: Covering Letter and Declaration Part 2: General and Technical Proposal Part 3: Financial Proposal Part 1: Covering Letter and Declaration Proposals must be accompanied by a covering letter on company-headed paper showing the full registered and trading name(s), trading and registered office address and business number of the Respondent. The letter must be signed by a person of suitable authority to commit the Respondent to a binding contract. It must quote the RFP number and title, and include the following declarations: a. We have eamined the information provided in your Request for Proposals (RFP) and offer to undertake the work described in accordance with requirements as set out in the RFP. This proposal is valid for acceptance for 6 months and we confirm that this proposal Page 6 of 31

7 will remain binding upon us and may be accepted by you at any time before this epiry date. b. We accept that any contract that may result will comprise the contract documents issued with the RFP and be based upon the documents submitted as part of our proposal. c. Our proposal (Technical and Financial) has been arrived at independently and without consultation, communication, agreement or understanding (for the purpose of restricting competition) with any other Respondent to or recipient of this RFP from NI. d. All statements and responses to this RFP are true and accurate. e. We understand the obligations regarding Disclosure as described in the RFP Guidelines and have included any necessary declarations. f. We confirm that all personnel named in the proposal will be available to undertake the services. g. We agree to bear all costs incurred by us in connection with the preparation and submission of this proposal and to bear any further pre-contract costs. h. I confirm that I have the authority of [insert name of NGO/company/agency] to submit this proposal and to clarify any details on its behalf. Part 2: General and Technical Proposal The General and Technical section should be structured as follows: Section 1: Your understanding of the TOR provided with this RFP as Anneure 1. You may also propose qualifications to the TOR that you consider may enhance the value of the outcome to NI. Section 2: Technical Response: a concise description of the methodology, tools and approach that are proposed for the delivery of the TOR and an implementation plan in the form of a work breakdown analysis. This should describe the activities to be undertaken, the deliverables / outputs and the milestone and completion dates (grouped by phase where appropriate). The dependency of any activities and associated results on earlier results needs to be clearly indicated. Section 3: Personnel Profile: names, designation and Curricula Vitae (CV) of personnel assigned to work on the Project. CVs must not eceed 3 pages, but must include: o a brief summary of the professional competencies of the individual relevant to the Scope of Work/TOR o a chronological list of relevant professional eperience starting with the most recent and showing key achievements / responsibilities o brief details of qualifications educational / technical / professional / other o language competencies other than English (corresponding to targeted provinces) Section 4: Personnel Inputs: include name of personnel, and person days with reference to project post. This will constitute a confirmation that all personnel will be available to provide the required services for the duration of the contract Page 7 of 31

8 Section 5: Company Information: proof of incorporation for registered incorporated entities, And/or proof of registration with the Philippines Securities and Echange Commission (SEC). Previous eperience: documentation demonstrating the Respondent s eperience in the proposed area of work. This should include contact details for key clients who may be contacted in respect of the Respondent s relevant prior work. Section 3: Required Qualifications of the agencies: Agency/NGO with at least 5 years of demonstrated eperience of implementing Health and Nutrition programs through the Department of Health, Department of Education or the Department of Social Welfare and Development and should have good liaison with key national and local government officials. Agency/NGO should also have team members with a public health nutrition background, who would be placed in the provinces to implement the project. Robust governance, risk and compliance management framework which, inter-alia, includes a strong internal control mechanism with effective program and financial management systems. In-depth understanding of functions of the DOH and the healthcare delivery system at the local government unit level. Part 3: Financial Proposal a. The Financial proposal must contain the epected budget with detailed breakdown for accomplishing the complete work. All amounts quoted must be in PHP. The Respondent should provide a detailed budget, based on the format attached as Anneure 2. b. Fees should be inclusive of all insurance and standard business overheads. c. Please note that no fees are payable for travel days. Page 8 of 31

9 I. Background ANNEXURE 1 TERMS OF REFERENCE Support to Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days Nutrition International (formerly Micronutrient Initiative) is a leading global technical agency working to improve nutrition of women and children in various countries including the Philippines. The organization s operations began in the Philippines in 2016 in collaboration with the Department of Health (DOH) and aims to influence policy, design and implementation of nutrition guidelines, and positively impact nutrition of women and children in the country. Nutrition International initially supported the National Nutrition Council (NNC) in the formulation of Philippines Plan of Action for Nutrition (PPAN) , launched in May The focus for this project to improve nutrition of women, infants and young children is well-timed to coincide with the PPAN launch. Anemia and Micronutrient Supplementation Among all the nutritional deficiencies worldwide, iron deficiency anemia is the most widespread nutritional deficiency. Anemia is a manifestation of under nutrition and poor dietary intake of iron which is a serious public health problem among pregnant women, infants and young children 6-23 months in the Philippines. Nearly 50% of all anemia cases is due to iron deficiency. It has devastating effects on health, physical and mental productivity affecting the quality of life, particularly among the vulnerable population. The National Nutrition Surveys (NNS) from 2001 to 2015 showed that 25% of pregnant women are nutritionally at-risk1 and that the same proportion (25%) is also anemic. The NNS 2013 also reported that among 6-11 month old infants the prevalence of anemia is 40.5% (categorized by WHO as of severe public health significance) and among children 12 months of age anemia prevalence is 24.7% (categorized by WHO as of moderate public health significance). Anemia poses a major threat to maternal and child survival, contributes to low birth weight, lowered resistance to infection, poor cognitive development and decreased work productivity. The prevention and control of anemia therefore is one of the key strategies for reducing maternal, neonatal and childhood mortality and improving maternal and childhood health status. Iron folic acid (IFA) supplementation is one of the major public sector interventions to reduce the anemia level among pregnant women. In the eisting health care delivery system in the Philippines, IFA supplements are delivered during ante-natal care (ANC) visits. The DOH Administrative Order (AO) No : Guidelines on the Provision of Quality Antenatal Care in All Birthing Centers and Health Facilities Providing Maternity Care Services already stipulates the provision of nutrition counseling, micronutrient supplementation and supplemental feeding program (when appropriate). Nearly all (95%) of women in the Philippines received ANC from skilled health provider and 84% had 4 or more pre-natal visits. However, while 92% took any iron supplements during their last pregnancy, only 7.2% 1 Based on weight for height classification: P<95 = nutritionally at risk; P95 or > = not nutritionally at risk (Magbitang et. al, 1988) Page 9 of 31

10 took (90 +) IFA tablets (NNS, 2015) 2 which indicates that coverage of the minimum efficacious dose for IFA supplements is poor. The DOH also introduced Micronutrient Powder (MNP) supplementation for infants and young children 6-23 months through the issuance of Department Memorandum which aims to improve their micronutrient status and reduce anemia through home fortification of complementary foods. MNP is delivered during growth monitoring and promotion activities, epanded Garantisadong Pambata services or during home visits. However, data from the 2015 FHSIS showed that only 20% of infants and young children 6-23 months had received MNP. Breastfeeding and Complimentary Feeding Growth restriction during intrauterine life and poor nutrition in the first two years of life has critical consequences throughout the life-course. Appropriate breastfeeding and complementary feeding practices not only play a significant role in improving the health and nutrition of young children but also confer significant long-term benefits during adolescence and adulthood. Improvement of eclusive breastfeeding (EBF) practices, adequate and timely complementary feeding, along with continued breastfeeding for up to 2 years or beyond, could save the lives of millions of children under 5 years of age annually. While 65.1% of mothers initiated breastfeeding within 1 hour after delivery (NNS 2015), only 24.7% of 5 month old infants are eclusively breastfeeding (NNS, 2015). Among 0-5 month old infants, 29.2% are already introduced to complimentary foods and 22% are given commercial milk formula (NNS, 2015). Timely complementary feeding at 6 months declined from 72.8% in 2011, to 65.8% in 2013 (NNS, 2013). In addition, only 29.2% of infants 6-23 months met the minimum diet diversity of four food groups and only 18.6 % were fed a minimum acceptable diet (NNS, 2015). Right Start in the first 1,000 days The DOH already adopted the framework of first 1,000 days for the delivery of integrated package of maternal, newborn and child health and nutrition (MNCHN) services which aims, among others, to prevent anemia among pregnant women, promote optimal breastfeeding practices, promote consumption of healthy diversified complimentary feeding, and improve micronutrient status and prevent anemia among infants and young children. However, eisting policies, guidelines and systems still need to be aligned, updated, revised or developed to help reduce missed opportunities and epand and or enhance nutrition services delivery during the first 1,000 days at the local government level. Strengthening Maternal and Child Nutrition Specific Services in the First 1,000 Days 2 Data from the Philippines 2013 DHS showed that 46.1% of mothers took iron with folic acid tablets or capsules during the pregnancy of last birth. This however, this does not specify if they took the tablets for 90 days or more. The DOH is more interested on consumption data for 90+ IFA (minimum efficacious dose). The project s baseline data of 7.2% (NNS 2015) will be further validated in the planned baseline survey to be conducted at Year 1. Page 10 of 31

11 Nutrition International, in partnership with the DOH and local government units, will help strengthen nutrition interventions for pregnant women and newborns (PWN), and infants and young children (IYCN). These interventions include IFA and MNP supplementation, the promotion of optimal breastfeeding and complimentary feeding practices which supports the operationalization of the Micronutrient Supplementation Program and the National Dietary Supplementation Program respectively which are both prioritized under Nutrition Specific Programs identified in the PPAN Technical assistance will be provided for the alignment of national policies, guidelines, jobaids or tools for nutrition interventions in the first 1,000 days; develop the nutrition specific component of LGU nutrition action plans and corresponding local issuances to support its implementation; convene, orient/ enhance capacity of community based support groups to provide continuum of nutrition services for pregnant women and children 0-23 months; strengthen supply chain mechanisms; improve tracking of clients and increase uptake of nutrition commodities/services across the first 1,000 days; and enhance recording, reporting and management of data. NI is seeking an agency/ngo implementing partner to support the roll-out of the above mentioned project activities in collaboration with the DOH in 5 selected provinces from September 2017 until March II. Project Objectives Overall Objective Support the Philippines Department of Health in Strengthening Maternal and Child Nutrition Specific Services in the first 1,000 days. Specific Objectives The specific objectives for the project are as follows: 1. Develop, revise and/or update policies, guidelines on the delivery of nutrition services (micronutrient and dietary supplementation, nutrition education and counseling, and food fortification) in the first 1,000 days. 2. Strengthen DOH systems in the delivery of nutrition services as part of MNCHN strategy. 3. Strengthen LGU capacity in planning, implementation and management of nutrition specific services. 4. Increase coverage of the following nutrition services or interventions: For pregnant mothers IFA supplementation to reduce micronutrient deficiencies (especially anemia) For infants Community-level promotion and support for eclusive breastfeeding among infants 0-5 months Page 11 of 31

12 MNP supplementation for infants 6-23 months to improve the quality of the complementary foods and reduce micronutrient deficiencies (especially anemia) III. Strategic Approaches Continuum of nutrition specific interventions in the first 1,000 days The DOH already achieved substantial gains in increasing provision of ANC by skilled health workers and improving delivery of services. Related interventions therefore were not prioritized in the NI Philippines Country Implementation Plan (CIP). However, in response to the epressed need from the DOH, the focus of interventions is on the development and/or strengthening of the nutrition services for pregnant women, infants and children 0-23 months, especially IFA supplementation for pregnant and postpartum women, promotion and support for eclusive breastfeeding for infants 0-5 months, introduction of complementary foods at si months of age, continued breastfeeding and MNP supplementation for children 6-23 months. Given the DOH framework for integrated service delivery in the first 1,000 days, project activities for both Pregnant Women, Infants and Young Children interventions will be jointly conducted because of the following considerations: While service delivery platforms are different [antenatal care services for pregnant women; Growth Monitoring and Promotion activities, Epanded Garantisadong Pambata (GP) services and home visits for infants and young children], both interventions are delivered by the same health providers at the health center and community level. Both interventions share the same targeted population for continuum of services for the mother and her child (pregnant women to mothers of children 0-24 months). Engagement of community-based peer support groups and Client tracking Building on the gains/eperience of LGUs with the engagement of breastfeeding support groups, peer-to-peer approaches will be further enhanced and epanded to support community maternal nutrition and infant and young child feeding education and counseling activities at the barangay level. Nutrition and Breastfeeding Support Groups (NBSG) will be convened when there is none, or reconstituted to include pregnant women and those with children less than 24 months of age if there is an eisting breastfeeding support in the community. Under the supervision of the midwife, Barangay Health Workers (BHWs) and Barangay Nutrition Scholars (BNS) will be designated as co-facilitators for this support group to help catalyze cooperation and collaboration between these two groups of community health workers. Regular meetings of the support groups will be supported by the project to also serve as the platform for the conduct of client tracking activities to reduce or prevent missed opportunities and help ensure delivery of continuum of nutrition services for mother and child in the first 1,000 days. Client tracking activities will also build on earlier DOH initiatives on follow-up of ANC clinic attendees and breastfeeding support groups and will involve the following: Page 12 of 31

13 NBSG facilitators (BHW and BNS) will identify and masterlist pregnant women and mothers of infants/children 0-23 months in the community (barangay) During the nutrition and breastfeeding support group meetings, these facilitators will: o o o o o follow-up compliance of pregnant and postpartum women to ANC and PNC visits track recommended intake of micronutrient (e.g. IFA and Calcium) and dietary supplements follow-up compliance of lactating mothers and/or caregivers and track eclusive breastfeeding for infants 0-5 months monitor potential violations to the eisting milk code in the country follow-up timely introduction of complementary foods/minimum acceptable diet (composite of dietary diversity and feeding frequency) o track proper preparation and utilization of MNP supplements for infants 6-23 months. Where feasible, the NBSG facilitators will also conduct home visits to observe and validate EBF practices including intake of micronutrient supplements. In locations where additional nurses are deployed under the DOH Nurse Deployment Program (NDP) to support Family Health Program services, the project will eplore to tap these nurses to support the conduct of meetings of the nutrition and breastfeeding support groups (e.g. as resource person) including tracking clients for nutrition services (clinic visits and consumption of micronutrient supplements) in their assigned households. Moreover, the project will also eplore collaboration with the Pantawid Pamilyang Pilipino Program (4Ps) of the Department of Social Welfare and Development (DSWD) at the community level for tracking of nutrition services among pregnant women and children 0-23 months in beneficiary families. Currently, compliance to basic health services are included as requirement under the conditional cash transfer program for beneficiary families. Adequate consumption of IFA tablets by pregnant women will be requested to be monitored for each ANC visit complied, including adequate consumption of MNP for infants/young children 6-23 months during scheduled clinic visits. Nutrition service delivery audits and Client case management Client tracking activities as discussed above will be linked to the conduct of monthly nutrition service delivery audits (NSDA) to be convened by the Municipal Health Officer together with the Municipal Nutrition Action Officer. Facilitators of the Nutrition and Breastfeeding support groups in the barangays will asked to report on their accomplishments (eg. number of support group meetings convened, number of women who attended the meetings vis a vis targeted participants, consumption data for IFA and MNP, eclusive breastfeeding vis a vis targets). The NGO Provincial Project Coordinator (PPC) with the assistance of the Midwife (supervisor of the facilitators) will help conduct random validation of the reports. These meetings will also serve to review cases of problematic clients (e.g. unable to comply with clinic visits, consume suggested quantities of micronutrient supplements or eclusively breastfeed infants 0-5 months) and identify solutions to further assist these clients. Moreover, Page 13 of 31

14 success stories could also be analyzed and discussed so BHWs and BNS learn and adopt approaches which may be useful in the delivery of nutrition education, counseling and client tracking activities in their barangays. Conduct of audit/case management meetings will be supported by the project to also help promote accountability of health service providers (at the facility and community level) for delivery of continuum of nutrition services in the first 1,000 days. Consumption data generated from the NBSG meetings and additional information gathered from the nutrition service delivery audits will further help inform program planning and budgeting process at the local and national level. IV. Implementing Partners The project will contract two implementing partners, UNICEF and an NGO partner. Details of these partnerships are as follows: Recognizing its technical leadership in children s health and nutrition, in collaboration with NI, UNICEF will be engaged for the revision, updating or development of DOH national policies and guidelines on nutrition services for the first 1,000 days. Nutrition International and UNICEF will also commission a qualitative formative research to inform the development and/or enhancement of a behaviour change intervention (BCI) plan, including materials and job aids for use of service providers. Moreover, an assessment of the logistics supply chain and delivery mechanisms in the UNICEF project sites will be conducted to help address availability of nutrition commodities (e.g. micronutrients). Outputs (products) from this engagement will be used to guide and accelerate implementation of project activities at the local government level. Furthermore, UNICEF will implement project interventions in the following areas: Regions (2) Provinces (3) Municipalities (5) Region V Camarines Norte Mercedes Basud Capalonga Masbate Monreal Region IX Zamboanga del Norte Leon Postigo (Bacungan) These areas are also DOH priority areas for nutrition interventions (anemia prevalence among pregnant women is high and MNP coverage is nil or low) which are identified under UNICEF s country program of assistance. The UNICEF component of the project will be contracted separately and is not covered by this RFP. A suitable NGO partner (to be identified through this RFP) will be engaged by Nutrition International Philippines to implement project interventions in additional DOH priority areas outside of UNICEF country program assistance sites as follows: Page 14 of 31

15 Regions (3) Provinces (5) Municipalities (49) (to be determined) Region VI Iloilo 10 Antique 10 Region VII Cebu 10 Bohol 10 Region XI Davao del Sur 9 3 The NGO partner to be engaged must have eperience in implementing both maternal and child health and nutrition interventions, and had previously worked with national and regional DOH and local governments. National level products from the upstream work of the Nutrition International-UNICEF project as described above will also be utilized to support and accelerate implementation of project interventions in the additional implementation sites identified for the NGO partner. V. Project Outputs and Activities Outputs and activities corresponding to each of the Project Specific Objectives are enumerated under the following interventions below: ENABLING ENVIRONMENT Output [1.1]: DOH policies and guidelines on delivery of nutrition specific services in the first 1,000 days developed, updated and/or revised: (corresponds to Objective 1) a) Policies and guidelines on nutrition of women of reproductive age (WRA), including pregnant and post-partum women b) Updated policies on infant and young child feeding (IYCF) c) Updated Manual of Procedures (MOP) on Micronutrient Supplementation d) Pocket type operational guide for service delivery at the LGU level in the first 1,000 days including GP. Activity [1.1.1]: Conduct consultation meetings/workshops among stakeholders and partners on the development, revision/updating of policies and guidelines on nutrition services (co-funded by DOH and Nutrition International-UNICEF Project) Activity [1.1.2]: Conduct validation meetings with stakeholders and partners on the developed/revised policies and guidelines (co-funded by DOH and Nutrition International- UNICEF Project) Output [3.1]: LGU Nutrition Action Plan (LNAP)- Nutrition Specific Services with costed implementation budget and financing strategy developed [joint activity with NNC] (corresponds to Objective 3) 3 There are only a total of 9 municipalities in Davao del Sur (ecluding the capital city) Page 15 of 31

16 Activity [3.1.1]: Conduct advocacy meetings at the provincial level (back to back with Activity 3.1.2) The Philippine Plan of Action for Nutrition (PPAN) was recently launched by the National Nutrition Council (NNC). The plan will be operationalized with the development of Local Nutrition Action Plans (LNAP) at the provincial and municipal levels. Advocacy meetings will be conducted at the provincial level to: situate and/or update the LGUs/local chief eecutives on the nutrition status and challenges in the province or municipality orient LGUs on the revised DOH policies and guidelines on nutrition specific services in the first 1000 days advocate for LGU cooperation and support in the implementation on nutrition specific services for mother and child in the first 1,000 days Participants will include the maternal, IYCF and nutrition programs managers at the provincial and municipal levels. Where feasible, participation of local chief eecutives to these meetings will be prioritized. Activity [3.1.2]: Conduct of workshop to prepare LNAP (for nutrition specific services) with costed budget/financing strategies Following through the advocacy meeting as described above, representatives of local nutrition committees with the provincial and municipal development and planning officers will be convened to: update/revise their respective LNAPs to include nutrition-specific services in the first 1000 days estimate the costs for implementation of the nutrition services forecast and estimate the cost for their MN products, such as IFA tablets and MNPs identify funding mechanisms/develop funding strategy to ensure continued availability of adequate funds to support implementation of nutrition services The outputs of the workshops (LNAP component on nutrition specific services in the first 1,000 days) will feed into the broader LNAP which will be developed under the leadership of the NNC. Development of the broader LNAP, however, is not covered under this project. Output [4.1]: Enhanced Behavior Change Intervention (BCI) Plan in the first 1000 days targeting health service providers, pregnant women, mothers and caregivers (corresponds to Objective 4) Activity [4.1.1]: Conduct of qualitative formative research on KAP of health workers, pregnant women, mothers and caregivers on provision of and consumption of nutrition services (in Nutrition International-UNICEF project sites and NGO project sites) Activity [4.1.2]: Conduct of consultative workshops to develop or enhance BCI Plan and materials for use by LGU service providers (Nutrition International-UNICEF Project) Page 16 of 31

17 Activity [4.1.3]: Reproduction and distribution of BCI materials Output [3.3]: LGU issuances in support of the nutrition program implementation in the first 1,000 days (corresponds to Objective 3) Provision Activity [3.3.1]: Conduct of consultation meetings to prepare the LGU issuance (administrative order, resolution or ordinance) in support of nutrition program implementation in the first 1,000 days Activity [3.3.2]: Conduct of validation meetings to finalize the LGU issuance Output [3.2]: LGU health workers oriented on the delivery of nutrition services in the first 1,000 days (corresponds to Objective 3) Activity [3.2.1]: Consult/coordinate with DOH and NNC in the integration of revised policies and guidelines on nutrition services in the first 1,000 days in the eisting training activities for maternal and child health services. Activity [3.2.2]: Conduct orientation for health service providers on the revised policies and guidelines on nutrition services in the first 1,000 days including tracking and data management. Activity [3.2.3]: Assist the DOH, NNC and LGUs in the conduct of monitoring, on-site mentoring and coaching of service providers on the delivery of nutrition services in the first 1000 days (especially IFA supplementation for pregnant and postpartum women, promotion and support for eclusive breastfeeding for infants 0-5 months, introduction of complementary foods at si months of age, continued breastfeeding and MNP supplementation for children 6-23 months). Output [2.1]: Enhanced logistics management of nutrition commodities at the provincial to municipal levels (corresponds to Objective 2) Activity [2.1.1]: Assess nutrition supply chain and delivery mechanisms from provincial to municipal levels and identify potential solutions to prevailing bottlenecks (in Nutrition International-UNICEF project sites) Output [2.2]: Tracking mechanisms and integrated data management for nutrition services in the first 1000 days (corresponds to Objective 2) Activity 2.2.1]: Conduct consultation meetings on tracking mechanisms and data management at the facility level for nutrition specific services for mother and child in the first 1,000 days The objective of this consultation is to identify mechanisms and/or strategies for tracking clients (pregnant women, infants and young children) to ensure their compliance to scheduled health facility visits and the uptake or utilization of recommended nutrition specific services. Outputs will include the development or enhancement of: Page 17 of 31

18 user-friendly tracking tool for use by midwives and community-based nutrition and breastfeeding support groups to monitor timely and adequate provision of nutritionspecific services from pregnancy to delivery up to the first 2 years of the child s life Data management system for nutrition specific services for mother and child in the first 1,000 days. Eisting target client lists for pregnant women and for infants/young children will be linked and/or aligned with the first 1000 days framework to support tracking of consumption of continuum of services from mother to child. Activity [2.2.2]: Collaborate with and support DOH in the conduct of LGU orientation on tracking mechanisms and integrated data management for nutrition specific services for mother and child in the first 1000 days. (part of Activity 3.2.2) Activity [2.2.3]: Conduct of monthly audit/case management meetings at the municipal level for nutrition specific services for mother and child in the first 1,000 days. CONSUMPTION Output [4.2]: Pregnant women, mothers and caregivers capacitated on optimum nutrition knowledge and practices (corresponds to Objective 4) Activity [4.2.1]: Orient Barangay Health Workers (BHWs) and Barangay Nutrition Scholars (BNS) in organizing or convening nutrition and breastfeeding support groups in communities Activity [4.2.2]: With BHWs and BNS as co-facilitators, support the nutrition and breastfeeding support groups to: identify and masterlist pregnant, women and mothers of infants 0-23 months in the community (barangay) Correct misconceptions, provide new information and share success stories on maternal and child nutrition especially on IFA supplementation, dietary supplementation for nutritionally at risk pregnant women, eclusive breastfeeding, complementary feeding, continued breastfeeding and MNP supplementation of complementary foods. Conduct interpersonal counseling to help promote and support improved maternal and child nutrition/feeding practices and improve adherence to micronutrient and dietary supplements. Follow-up compliance of pregnant and postpartum women to ANC and PNC visits and track recommended intake of micronutrient and dietary supplements. Follow-up compliance of lactating mothers and/or caregivers to eclusive breastfeeding for infants 0-5 months, timely introduction of complementary foods, dietary diversity and feeding frequency, and track proper preparation and utilization of MNP supplements for infants 6-23 months. Page 18 of 31

19 Activity [4.3]: Assist the DOH and LGUs in the conduct of monitoring, mentoring and onsite coaching of pregnant women, mothers and caregivers on the adoption of desired nutrition behaviors during the first 1,000 days. (corresponds to Objective 4) VI. Key Collaborative Activities with DOH Collaboration with and support of the DOH is central to the implementation of the project. The following are identified key collaborative activities with the DOH: Updating, Revision or Development of Policies and Guidelines on Nutrition Services in the First 1,000 days As previously mentioned, the project through UNICEF will support the updating, revision or development of policies and guidelines on nutrition services in the first 1,000 days. The project will provide technical assistance to facilitate the workshop including the drafting and finalization of the documents. The DOH-Family Health Office will provide funding assistance to convene the workshop and support the participation of relevant national, regional, local and NGO partners. NI Philippines country office staff and the NGO partnerwill actively participate in the consultation meetings and workshops convened for this activity. Capacity Building At the request and instructions of the DOH-FHO, no new training curriculums will be developed under the project. Instead, nutrition related capacity building requirements will be incorporated in eisting training programs already implemented for both maternal care and infant and young child health and nutrition programs. The project will convene meetings with the national DOH for purposes of integrating additional nutrition related content into eisting training curricula. DOH will eecute the updates in their planned training activities in the project sites. In areas where DOH had no planned or scheduled related training activities, the project will provide orientation/update sessions on revised policies/ guidelines, job-aids and tools on nutrition services in the first 1,000 days to health service providers. Commodity Procurement The project is primarily designed as a technical assistance project and will not be able to support procurement of nutrition/micronutrient commodities or supplies. As discussed and agreed with the DOH-FHO, all micronutrient and dietary supplements, (e.g. IFA tablets and MNPs) to be used in the project sites will be procured by the DOH for the 3- year duration of the project. The DOH Nutrition Program Coordinator will ensure that 100% of the following micronutrient supply requirements will be made available in all selected project sites: Page 19 of 31

20 Iron Folic Acid tablets Micronutrient Powder (MNP) Reproduction of BCC materials and job-aids for health service providers The Nutrition International-UNICEF project will support the updating/revision of eisting jobaids for health service providers on the delivery of nutrition services in the first 1,000 days. Initial printing of these materials will also be supported in both UNICEF and additional NGO project sites. However, funding assistance will be needed from DOH to reproduce additional copies and ensure continued availability of these materials in the project sites. Project Oversight and Monitoring of Implementation The DOH will provide oversight in the overall implementation of the project. The FHO will calendar project updates in the following eisting program management platforms as appropriate: DOH Infant and Young Child Feeding (IYCF) Technical Working Group (TWG) DOH Adolescent Health Development Program TWG DOH Program Implementation Review Meetings: Maternal Care, IYCF, Nutrition The DOH-FHO will also invite Nutrition International Philippines and project staff in the conduct of planned program monitoring activities in the identified project sites. Moreover, DOH-FHO will also help convene and participate in monitoring and implementation reviews planned under the project. VII. Phasing of Project Implementation The project will be implemented in phases as follow: Year 1 (September March 2018) Conduct of LGU visits/briefings on Nutrition International/Right Start Project Conduct of formative assessments Conduct of assessment of logistics supply chain and delivery mechanisms for nutrition commodities (Nutrition International-UNICEF project sites) Conduct of baseline survey Development, revision and/or updating of national policies and guidelines on the delivery of nutrition services in the first 1,000 days as part of the MNCHN strategy (led by Nutrition International-UNICEF Project) Development of BCI plan, and job-aids/tools for service providers at the LGU level to focus on nutrition interventions in the first 1,000 days (led by Nutrition International-UNICEF Project) Conduct of Project Annual Planning for Year 2 Page 20 of 31

21 Development of LGU Action Plans on nutrition specific interventions Preparation of LGU issuances in support of nutrition programs Strengthening capacity of DOH and LGUs in planning, implementation, monitoring and evaluation of nutrition services Year 2 (April 2018-March 2019) Continued capacity strengthening for LGUs on implementation, monitoring and evaluation of nutrition services Finalization of LGU issuances in support of nutrition programs Implementation of the nutrition services in priority provinces Monitoring and supervision Conduct of Project Implementation Review with Annual Planning for Year 3 Year 3 (April 2019-March 2020) Continued capacity strengthening for LGUs on implementation, monitoring and evaluation of nutrition services Continued implementation of the nutrition services in priority provinces Continued monitoring, supervision Conduct of End-line Survey (End of Project Evaluation) Documentation, dissemination and advocacy for scaling up of interventions VIII. Project Monitoring Monitoring activities will be conducted throughout all phases of project implementation and will include the following: NGO Provincial Project Coordinators (PPCs) will monitor project implementation at the municipal and barangay levels and participate in monthly meetings convened by the LGUs, including meetings of the Nutrition and Breastfeeding Support Groups at the barangay level. These PPCs will also provide needed technical assistance as maybe identified during the monitoring visits. Quarterly field visits will be conducted by the DOH/UNICEF/Nutrition International/NGO partner to monitor progress of project implementation and also provide technical support to ensure adequate and timely delivery of quality nutrition interventions. Feedback on findings will be provided to LGUs to guide corrective and enhancement measures. Service delivery data (provision) will be generated through the DOH-Field Health Service Information System (FHSIS) emanating from rural health units (RHUs) and Barangay Health Centers (BHCs). Page 21 of 31

22 Monthly audit/case management meetings will be convened at the municipal level for nutrition services for mother and child in the first 1,000 days. Consumption data will be reported by BNS and BHWs (facilitators of the Nutrition and Breastfeeding Support Groups) during the conduct of these meetings. DOH Regional Nutrition Program Coordinators, with assistance of the NGO PPCs will gather and consolidate municipal program performance data into quarterly provincial project reports. Nutrition-related performance indicators for the first 1000 days will be reported quarterly to the DOH by the DOH Regional Nutrition Program Coordinators with assistance from the NGO National Project Coordinator (NPC). Annual Project Implementation Reviews (PIR) will be convened by DOH, UNICEF, Nutrition International and NGO Partner. The activity will serve as the venue for identifying technical, operational and structural issues and concerns and propose recommendations to address the same. The annual PIR will be conducted in tandem with the operational planning for the succeeding year. IX. PROJECT EVALUATION The following are assessment and evaluation activities planned to be conducted during the life of the project: 1. A qualitative formative research study will be conducted in Nutrition International -UNICEF project sites and NGO project sites at the start of project implementation. Results of this research study will inform the development of BCI plan and materials and/or modification of eisting job-aids or tools to be used by health service providers for nutrition services delivery in the first 1,000 days. 2. A baseline survey will also be conducted at Year 1 of the project to validate and/or determine service delivery data (provision at the health facility and consumption at the household level) for nutrition services at the project sites. Consumption data (e.g. IFA and MNP) are currently not available under the eisting reporting system. 3. Assessment of logistics supply chain and delivery mechanisms for nutrition commodities from provincial to municipal levels in Nutrition International - UNICEF sites at Year 1 of the project. The assessment will utilize bottleneck analysis to: identify problems and gaps encountered by LGUs clarify accountabilities at each level with regards to the procurement, delivery, storage and distribution of commodities for nutrition services in the first 1000 days strengthen on-time delivery and reduce stock-outs. The participants will include Budget/Finance Officers, Health/Nutrition program managers, supply/stock officers among others. The epected output is an operational guideline on enhanced logistics management system of nutrition commodities which will be shared with other project sites to also help improve availability of needed commodities in these areas. Page 22 of 31

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