Background/ Context
Marsabit County is located in the former Eastern province of Kenya and covers an area of 70,961.3 Km2 and is ranked as the largest county in the country. The county remains amongst the counties with the highest poverty index in the in Kenya and ranked position 44 out of 47 counties with a poverty rate of 83.2%. The county has three major livelihoods where the pastoral livelihood zone forms the bulk of the main livelihood zones at 81% and the other significant livelihood type is the agro-pastoral system which accounts for about 16% of the population.
The county experiences poor health and Nutrition outcomes especially due tCommunity Referral system is poor since community units are there but semi Functional and community Health services are poor hence most health facilities are not able treach their catchment population. There has been nobvious recovery from the persistent shocks including drought, floods, and conflict that the communities are faced regularly with, thus illustrating very high levels of chronic vulnerability.
The major drivers of the high levels of acute malnutrition in the county have for a long time remained as chronic food insecurity, poor dietary diversity, suboptimal child care and feeding practices including poor hygiene and sanitation , low access tessential health and nutrition services and poor health seeking behaviour which directly influence access tbasic quality health services .The July 2017 survey alshighlighted the specific vulnerabilities related thygiene and sanitation with less than 16.9% of the respondents practicing hand washing at four critical times and more than half of the population (58.7 %) practicing open defecation. Furthermore only 21.7% % were treating their water for drinking (2017 SMART Survey).
Infant and Child breastfeeding practices are sub optimal with intitiation of infants tbreastfeeding with the first hour of birth at 84.4 % and exclusive breastfeeding for first six months at 68.2 % (Marsabit SMART survey, 2013). A KAP survey conducted in Marsabit County in 2017 identified cultural practises around child naming ,home deliveries and perceptions of not enpough milk and baby crying tomuch as main negative influences toptimal brestfeeding practises.
Complementary feeding practices are largely sub-optimal with complementary foods usually sub-standard in nutrient quality and quantity. Complementary foods used largely comprise of starches that are low in proteins and other nutrients vital for the growing infant (Marsabit SMART survey, County 2017). In addition, complementary feeding diets are typically limited in diversity and dnot meet the nutrient requirements of the growing child. The 2017 SMART Survey indicated poor timely introduction of complementary foods at 53.8 % with only 8 % children 6-23 months achieving minimum acceptable diet .In addition dietary diversity score was poor at 12.1 % .This situation is further compounded by household food insecurity due tlow purchasing power, lack of diversity of food owing tmarket limitation coupled with poor food preparation methods, food taboos and inadequate knowledge on MIYCN practises.
Table 1: Summary of Infant and Young Child Nutrition Indicators in Marsabit County
Indicator
Age group
Percentage
Timely Initiation tBreast milk
0 – 23
84.4%
Exclusive Breastfeeding
0 – 5
68.2%
Introduction of Solid, Semi-Solid, or Soft Foods
6 – 8
44.3%.
Minimum Dietary Diversity
6 – 23
15.5%
Minimum Meal Frequency (6-8 months)
6 – 8
1.2%
Minimum Meal Frequency (6-23months)
6 – 23
16.6%
Minimum Acceptable Diet
6 – 23
15.6%
Source: Marsabit County, KAP survey, Dec 2017
Objective/Purpose of the Consultancy
Tanalyse existing nutrition data for Marsabit County with a view of coming up with the nutrition profiles for the County.
Methodology
Nutrition profile provides an assessment of the Country’s performance against the nutrition related indicators, and aggregates the results intdials tprovide an overall assessment of child welfare. The countries are assessed using the global targets. They offer a powerful tool for quantifying the scale of the challenge posed by the targets and identifying areas where the most effort is required treach targets or improve monitoring. The profiles accompany the report showing progress for every child. Currently, analysis of nutrition information normally exists at country level and there is need thave a County level analysis tshow progress in the performance of nutrition indicators thave a county specific profile.
This analysis will adopt a desk review of existing information tdocument what has been the pattern. Concern will avail some of the useful documents. The Consultant will be expected tdraw from previous surveys, the KDHS and other relevant sources for this assignment. Additionally, the consultant will conduct interviews with key persons in nutrition for Marsabit and with partner’s staff for qualitative information.
The consultant is expected tdevelop a clear methodology, work plan, develop interview guide, analyse data, profile and submit a report.
Deliverables/Outputs
Inception report with an analysis of the context based on existing information on nutrition for Marsabit County including proposals for data analysis plan and methodology
A draft data analysis report
A final data analysis report containing stand-alone executive summary with clear nutrition profiles for Marsabit County
Proposed Timelines
The Consultant should include a proposal of the number of days the assignment will take.
Remuneration
The Consultant is expected tprovide a financial proposal for the whole assignment. Agreed rates will be based on prevailing market competitive rates and value for money.
Payment will be made upon verification of the final work by Concern Worldwide’s Programmes Director.
Expertise and Skills Required
At least Master Degree in a relevant field with proven track record of similar work
