ALIVE & THRIVE Issued on: 31 July 2014 For: Request for Proposals (RFP) Formative Research on Improved Infant and Young Child Feeding (IYCF) Practices in Burkina Faso Anticipated Period of Performance: September 1, 2014 January 30, 2015 Deadline: 20 August 2014 Background: Alive & Thrive (A&T) is an initiative to save lives, prevent illness, and ensure healthy growth and development. Good nutrition in the first 1,000 days, from conception to two years of age, is critical to enable all children to lead healthier and more productive lives. Alive & Thrive is scaling up improved infant and young child feeding and maternal nutrition through large-scale programs in several countries in Asia and Africa and through strategic technical support and the dissemination of innovations, tools, and lessons worldwide. Alive & Thrive is funded by the Bill & Melinda Gates Foundation and the governments of Canada and Ireland. The initiative is managed by FHI 360. A&T promotes a range of improved nutritional practices related to breastfeeding and early childhood feeding. They include: Initiation of breastfeeding within one hour of delivery Exclusive breastfeeding up to six months postpartum Complementary feeding with continuation of breastfeeding up to 24 months or beyond Context for formative research in Burkina Faso Burkina Faso is a landlocked country of approximately 16.5 million people and many ethnic groups. The population is predominantly rural (78%), with high levels of poverty (47%, 2010 estimate) and low functional literacy. Burkina Faso ranked 183 out of 187 in the 2013 Human Development Index that includes life expectancy, education, and standard of living. Dependent largely on subsistence agriculture, rural populations are vulnerable to frequent emergencies due to extreme climate fluctuations and food insecurity. With a history of drought and famine, the country s health and nutrition services have been oriented towards treatment of acute malnutrition. Preventive interventions such as breastfeeding have Page 1 of 8
not received adequate attention or priority. Opportunities in the health system are missed for promoting good feeding practices, and overburdened health systems and small-scale community-based programs limit coverage and the delivery of infant and young child feeding (IYCF) services at scale. Those IYCF services that do exist are often inadequate in quality and inequitable in access, resulting in poor uptake of good practices and limited impact as shown in table 1. Indicator % Early initiation of breastfeeding in 1hour 30.8 Exclusive breastfeeding <6 months 47.2 Median duration of exclusive 0.6 breastfeeding (months) Dietary diversity of complementary 7.5 feeding Minimum acceptable frequency of meals 53.4 Minimum acceptable diet 37.2 Underweight, moderate and severe 21 Stunting 31.5 Wasted 8.2 Low birth weight 16 Trials of Improved Practices (TIPS): The formative research described in this request for proposals should include an approach known as TIPS. The approach entails meeting with mothers or primary caregivers preferably in their homes-- to identify nutrition problems affecting children and to provide information about improved practices that are acceptable and feasible for families. Mothers or primary caregivers are then given a choice of recommendations to act on, questioned about their reasons for that choice, and then followed up to see what actually happened. Were they informed of the new practice of the IYCF? If yes, did they try the new practice, and if so, how did they feel about it? Did they modify it? Or if they didn t try it, why not? In this way the proposed recommendations are tested in a real environment, and information is gathered on their acceptability. This information helps program planners to set priorities among the many seemingly important feeding practices and messages. In addition, researchers and/or counselors can learn a great deal about how best to provide communication messages, including: The relative ease or difficulty of communicating various recommended practices; Modifications in the way the information is delivered that make the recommendations more acceptable; Unanticipated resistance points that limit behavior change; Page 2 of 8
Ways in which recommendations are undermined by practices such as dilution, replacement, or children s resistance to new foods; and The approximate proportion of families who are and are not able to modify feeding practices and improve nutrition without additional resources. TIPs test the feasibility of asking people to carry out the advocated behaviors. (This is different from pretesting educational materials and messages, which occurs much later.) Objectives This research will inform the development and/or adaptation of interpersonal and mass media messages aimed at improving IYCF practices in Burkina Faso. The research has three objectives: 1) Identify a range of improved feeding practices that would be acceptable to mothers of infants and young children 2) Document approaches to negotiating improved practices that are more (and less) persuasive in terms of mothers willingness to try out a new behavior 3) Identify barriers and facilitators to implementing improved practices, including recommendations from mothers, healthcare providers and other community members Scope of Work and Specific Tasks This formative research will be conducted in each of four regions to be selected in consultation with the MOH. In each region, three towns or villages will be identified from which to select a total of 7-9 women. A minimum of 2 and maximum of 4 women in each category below (per village) will be purposively selected to represent three infant-feeding contexts: a) Pregnant women (expecting to deliver within the next week); b) Mothers of neonatal infants (between 0-6 months); and c) Mothers of young children (below one year) In each village, women should be selected across these three categories who represent a range of parity and socio-economic status, so that the final sample includes at least 30 women who are first-time mothers and 12-14 women each in a range of household economic contexts (i.e., subsistence farming; single wage household; dual wage household or other criteria.) Repeated in-depth interviews will be conducted with a maximum total of 108 women. During the first visit, the data collector will explore current infant feeding practices and identify potential improved practices, as well as perceived barriers and facilitators of adopting new behaviors. In the second visit, the data collector will assess the mother s ability to undertake improved practices between the first and second visits, identifying any experienced barriers and facilitators as well as any recommendations the mother or her influential family members might have to facilitate adoption. In addition, either focus group discussions and/or individual interviews will be conducted with a range of healthcare providers in each region, including traditional birth attendants, nurses or midwives, to better understand how they currently counsel women on breastfeeding and early childhood diet and explore their perceptions of A&T improved feeding practices, including any recommendations they Page 3 of 8
might have for key counseling messages and implementation strategies. A minimum of 1 FGD and/or 5 IDIs will be conducted per region. Interviews will be audiotaped and transcribed. FHI 360 staff will work collaboratively with the selected research firm to synthesize findings. Collaboration includes the joint development of a codebook, teambased coding and synthesis. FHI 360 staff will lead or co-lead an analysis training and/or data synthesis workshop to enable a more rapid completion of the activities and ensure local perspectives and understandings of the data are taken into account. A synthesis of study findings should be available by January 31, 2015. Bidders are requested to propose the four regions in which data collection activities are conducted and justification for their selection. In addition, bidders are requested to describe their approach to the specific tasks listed below, addressing any questions that are included: 1. Local IRB Review (1 page) The protocol and data collection instruments will be submitted to two institutional review boards (IRB)/ethics committees (ECs). FHI 360/A&T staff will be responsible for submission to the Protection of Human Subjects Committee, which is FHI 360 s IRB. The selected research firm will be responsible for preparing and submitting the protocol and required documents to the local IRB/EC in Burkina Faso. In preparation for these submissions, the researcher/research firm will review and provide their input on a research protocol, data collection instruments and informed consent forms and procedures for the formative research. They will also ensure that topic guides and consent forms are translated and backtranslated into the appropriate local language(s) prior to submission. Please provide details of timeline and procedures for IRB/EC submission in Burkina Faso. When is the soonest that the IRB submission can be made in Burkina Faso? 2. Training and topic guide pretests (1 page) FHI 360/A&T staff will work with the research firm to ensure that data collectors are properly trained to conduct the in-depth interviews (including TIPS strategies) and any focus group discussions included in the protocol. Please provide your recommendations related to the following: How many data collectors/teams would you recommend to implement this study in four regions - with sufficient time to complete all data collection and analysis activities by January 31, 2015? What informational content and skillsets should be covered during the training? Please suggest a timeline and set of activities for the training 3. Recruitment (1 page) The researcher/research firm will be responsible for recruiting ample participants for individual interviews and for focus group discussions (no fewer than six participants per group but ideally 8-10 for each group) using methods agreed upon by researcher and the project. Researcher is responsible for procurement, compilation, and administration of recruitment lists and for tracking whether each data collection team is meeting their targets. What approaches would you recommend to recruit women and healthcare providers for this formative research? How would you ensure that participants are representative of the communities from which they have been recruited? Page 4 of 8
Please describe and/or provide an example of any data collection tracking tools that could be used to ensure there is sufficient variation in our sample of mothers and of providers. Please describe any approaches you would use to track follow-up visits for TIPS. 4. Research facilitation (1 page) The researcher/research firm will convene and facilitate each data collection event and audio-record or capture detailed, specific notes from each individual or group interview. All data will be translated into French and entered into word processing documents for analysis. Recordings and any notes must be provided to Alive & Thrive throughout the data collection period. Please describe a process for data collection, translation/transcription and review that would allow for periodic feedback from FHI 360/A&T staff. What personnel would conduct and review the transcription? How would you ensure data quality? Please provide a timeline for data collection activities. 5. Support on data analysis (1 page) The researcher or research firm shall work collaboratively with the FHI 360/A&T staff to analyze the interview and FGD transcripts. A detailed analysis and set of recommendations in the form of a written report will be delivered to Alive & Thrive on or before January 31, 2015. What experience has the researcher/research firm already had with qualitative data analysis? What specific technologies or software packages has the firm used for coding and data synthesis? What timeline is required for the analysis? FHI 360 staff can provide training on data analysis, if needed. Or, a data synthesis workshop could be conducted in Burkina to involve the research firm and data collection staff. Please describe any experiences the research firm has in training others in qualitative data analysis. Anticipated Period of Performance: August to January 2015 SUBMISSION REQUIREMENTS To be considered, bidders must provide the following (responses are preferred in English, but may be submitted in French): 1. Description of methodology and proposed approach for the formative research as described in the Scope of Work section above. Be sure to include the specific four regions selected and justification for why each was selected. (5 pages maximum) 2. Capacity and Experience Statements include the following: a. Company profile with solid background/knowledge in public health, maternal and child health, nutrition especially IYCF and understand nutrition, particularly breastfeeding, situation in Burkina Faso (and/or other francophone West African countries). Page 5 of 8
b. Short bios on proposed key personnel and CVs, if applicable. c. Examples of solid experience in conducting studies and evaluations in this area of policy. d. Show a demonstrated ability to submit and obtain ethics approval for similar research. e. Show a demonstrated ability to reach and connect with policy makers (to determine regions of focus and obtain authorization for data collection). f. Agency must provide a description of location(s) of presence relevant to this RFP. Agencies with research experience in identified regions preferred. g. Agency may include appendices that show examples of past work (which might include relevant topic guides, reports or papers highlighting qualitative research skills, qualitative data analysis plans), if appropriate. This is not mandatory. 3. Budget in the format provided by FHI. All quotes must be in local currency. To the extent that indirect costs are applicable, they are subject to the following limits: 0% for government agencies, other private foundations and for-profit organizations up to 10% for U.S. universities and other academic institutions Up to 15% for all other non-u.s. academic institutions and all private voluntary and nongovernment organizations, regardless of location. Indirect cost rates (and the limitations) apply both to the primary applicant organization and any sub-grantees and/or sub-contractors that are part of the proposal. 4. Three references for past performance, including contact information for each. The references should be for past customers for whom similar work was done. 5. The email address where Alive & Thrive may send a confirmation of receipt of your submission. CRITERIA FOR EVALUATION Bids will be evaluated and ranked by a committee on a best-value basis according to the criteria below. Only offerors able to provide all of requirements listed above may be considered. Selection shall be based on the following weighted categories: 1. Methodology and Proposed Approach for the Formative Research: 30% 2. Capacity and Experience: 30% 3. Completeness and Appropriateness of the Budget: 20% 4. References and Past Performance: 20% NOTE: FHI 360 will not compensate the company for its preparation of response to this RFP nor is the issuing of this RFP a guarantee that FHI 360 will award a contract. Page 6 of 8
Contract Mechanism FHI anticipates issuing a firm fixed-price purchase order. The purchase order will be issued in local currency (XOF) to the responsive offer that is selected on a best value basis. Once an award is issued, it will include a schedule of fixed price payments based on completion of deliverables in the scope of work. Instructions and Deadline Responses to this RFP should be submitted by email to the A&T office to Moulaye Sy at msy@fhi360.org no later than August 20, 2014 at 5 p.m. Washington DC US time. Please follow the instructions carefully. Proposals which do not follow these instructions will not be reviewed. Offers received after this date and time will not be accepted for consideration. FHI will acknowledge receipt of your proposal by email. Proposals must be submitted in electronic format using Microsoft Office compatible software. Please include VAT and any applicable taxes into the cost proposal as FHI 360 is not VAT or tax exempt. Withdrawal of Proposals Proposals may be withdrawn by written notice, email or facsimile received at any time before award. False Statements in Offer Offerors must provide full, accurate and complete information as required by this solicitation and its attachments. Proposals become property of FHI 360. DISCLAIMERS AND FHI 360 PROTECTION CLAUSES FHI 360 may cancel the solicitation and not make an award FHI 360 may reject any or all responses received Issuance of a solicitation does not constitute an award commitment by FHI Solutions FHI 360 reserves the right to disqualify any offer based on offeror failure to follow solicitation instructions FHI 360 will not compensate offers for response to solicitation FHI 360 reserves the right to issue an award based on initial evaluation of offers without further discussion FHI 360 may choose to award only part of the activities in the solicitation, or issue multiple awards based on the solicitation activities FHI 360 may request from short-listed offerors a second or third round of either oral presentation or written response to a more specific and detailed scope of work that is based on a general scope of work in the original RFP. FHI 360 has the right to rescind an RFP, or rescind an award prior to the signing of a subcontract due to any unforeseen changes in the direction of FHI 360 s client, be it funding or programmatic. FHI 360 reserves the right to waive minor proposal deficiencies that can be Page 7 of 8
corrected prior to award determination to promote competition FHI 360 will be contacting offerors to confirm contact person, address and that bid was submitted for this solicitation. END OF RFP Page 8 of 8