Introduction
Suaahara, a USAID-funded multi-sectoral program in Nepal operates at scale. In its first phase (2011-2016), Suaahara expanded into 40 of Nepal’s 75 districts and now in its second phase (2016-2021), Suaahara operates in 42 of Nepal’s 77 districts; in both phases a district-wide approach was used, meaning blanket coverage of key interventions in all communities throughout the intervention districts. Suaahara II is led by Helen Keller International with six core implementation partners: CARE, FHI360, Environment and Public Health Organization (ENPHO), Nepali Technical Assistance Group (NTAG), Vijaya Development Resource Center (VDRC) and Digital Broadcast Initiative - Equal Access Nepal (EAN). In addition, district-specific Partner Non-governmental Organizations (PNGOs) are Suaahara sub-recipient partners responsible for sub-national level implementation of activities.
The overall program objective is to reduce the prevalence of stunting, wasting and underweight among children under 5 years of age, underweight among mothers, and anemia among mothers and children. The program aims to achieve these objectives through a multi-sectoral approach, organized around a results framework with four intermediate results (IRs).
strengthened local governance
For IR1, Suaahara-hired frontline workers (FLWs) (Field Supervisors and Community Nutrition Volunteers) conduct household and community level activities to increase awareness and support families to engage in optimal practices. Additionally, Suaahara works alongside Nepal’s large cadre of Female Community Health Volunteers (FCHVs) as principal agents for change. FCHVs conduct face to face counselling, run women’s groups, and support behavior change at the household level through interpersonal communication and education activities.
For IR2, strengthening nutrition-related knowledge and skills, including counseling staff at health facilities and FCHVs working in the communities on health and nutrition is critical. Furthermore, Suaahara promotes and supports integration of nutrition into maternal and child health services, including growth monitoring and promotion, and works to improve service availability and quality related to family planning and maternal and child health.
For IR3, Suaahara supports reductions in food insecurity and improvements in diversity of food produced, consumed, and sold in markets (when surplus) in disadvantaged communities (about 45% of the wards), through its homestead food production (HFP) (vegetable gardening and chicken rearing) package, delivered through village model farmers (VMFs) established by the project (at varying points between 2012 and now) through selection and capacity building.
For IR4, strengthening Government of Nepal (GoN) systems (at all levels) for policy and program development and implementation to support sustainable improvements in nutrition is crucial. A key aspect of this relates to the allocation and utilization of government funds for nutrition-specific and nutrition-sensitive investments.
Suaahara uses a multi-platform Social and Behavior Change (SBC) approach to integrate across these thematic areas. The four primary means of reaching households include: interpersonal communication (IPC) (e.g. home visits); community mobilization events (e.g. health mothers’ groups and food demonstrations); mass media via a weekly radio program known as Bhanchhin Aama (now also available on Facebook and YouTube); and technology (e.g. SMS message campaign; interactive voice response).
Suaahara has a robust monitoring, evaluation and research (MER) system. Suaahara has been carrying out various qualitative and quantitative research studies, including: several rounds of formative research on key behaviors; a randomized controlled trial with related formative research and process evaluation; and a cohort study of adolescent girls becoming women. Suaahara also conducts annual surveys, with data collected externally to track progress over time in relation to inputs, outputs, outcomes and impacts in intervention areas. The annual surveys help to identify gaps in coverage and knowledge and practices related to Suaahara’s IRs. An evaluation is needed, however, to complement the monitoring surveys and enable findings that attribute changes over time to Suaahara.
Background
Before the start of Suaahara, an evaluation was planned and the International Food Policy Research Institute (IFPRI) was contracted to design the impact evaluation and lead the baseline survey of the impact evaluation in the summer of 2012. A Nepali survey firm was responsible for the baseline survey data collection and management. Additionally, in 2014 a mixed-methods process evaluation (de facto Suaahara I endline and Suaahara II) was carried out by an externally contracted principal investigator to lead the study design and locally-contracted firms to carry out the quantitative and qualitative components.
The endline for the main quasi-experimental impact evaluation of Suaahara will take place in the summer of 2020 and will estimate the effect of Suaahara interventions on household behaviors and nutritional status, as well as on knowledge and skills among health workers and FCHVs. To complement this quantitative study, a qualitative evaluation focusing on the effect of Suaahara at the FLW/community level and policy levels (federal, provincial/district and local) is also planned.
At the FLW/community level it is important to document and assess Suaahara efforts with both health and non-health workers and across both Suaahara and government FLWs and platforms. The primary and secondary research questions include: 1) What is Suaahara’s impact on improving nutrition-related awareness, knowledge and skills among health and non-health FLWs? and 2) To what extent did Suaahara reach health and non-health sector FLWs and did this impact their nutrition-related engagements with communities, particularly 1000-day households? Additionally, it is important to document and evaluate Suaahara’s policy-level interventions at all levels. The primary research questions for this study include: 1) What is Suaahara’s impact on improving cross-sectoral engagements, information exchange, and knowledge and skills among policy stakeholders? and 2) What is Suaahara’s impact on nutrition-related policies, plans and budgets/investments?
Tasks and Deliverables
The Qualitative Principle Investigator is required to collaborate with the Suaahara team, remaining in close consultation with the Sr. Technical Advisor and MER teams, as well as other research consultants hired for the evaluation, from design through to completion of the studies. Details of the tasks required under this contract are outlined below by phase:
The evaluation planning component will involve a review of the qualitative studies conducted in 2014/2015 focusing on policy environment and multi-sectoral FLWs, as well as a review of the findings from a recent governance study Suaahara conducted in a few program districts. During this planning period, meetings with program staff based in Kathmandu, particularly the governance and MER teams, will be important. During this period, the draft protocol with primary and secondary research questions and study tools will be shared with the Principal Investigator, who will finalize the protocol and tools in preparation for submission for ethical approval.
Deliverable: Final protocol and tools, as submitted to Nepal Health Research Council (NHRC) ethics (April 15)
Training for data collection will start in May, with data collection, followed by transcription and translation taking place in the summer. The Principal Investigator will need to finalize a data analysis plan and draft coding framework during this period and be available to answer any calls that emerge from the data collection team during training and data collection and management.
Deliverable: Data analysis plan and coding framework
In this last phase, the Principal Investigator, in close collaboration with the assistant qualitative researcher, will lead the analysis and interpretation for the primary research questions and will document the findings in a report and slide deck.
Deliverable: Written report and slide deck of key findings
Timeline and Level of Effort
February 1 to December 15, 2020 for a total of 55 days. The level of effort (LOE) is calculated according to the designated tasks, noted above. This scope of work requires approximately one week in Nepal during the preparatory phase (February) and up to two weeks of work in Nepal during the analysis and interpretation phase (Fall).
Qualifications/Evaluation Criteria
The top three candidates will be shortlisted by the technical evaluation committee. Based on a review of the application materials submitted and estimated costs, the evaluation committee will make a best value trade-off evaluation of the technical quality and the consultant’s daily rate, associated travel and incidentals costs to identify the successful candidate.
This consultancy will report to the Suaahara II Sr. Technical Advisor.
To Apply
Qualified candidates should submit a cover letter, resume, per day consultancy rate and total consultancy fee both, and a recent, relevant writing sample and biographical data sheet to Suaahara.Consultants@hki.org noting “Qualitative Evaluation Principal Investigator Consultancy” in the subject line. The biographical data sheet can be downloaded at the following address: http://hki.org.np/
Note
Questions on scope of work to be submitted by November 26, 2019 by 5:00 p.m. Nepal Time at Email: Suaahara.Consultants@hki.org with subject line: “Questions for Qualitative Evaluation Principal Investigator Consultancy.” The answers to questions on scope of work shall be posted on http://hki.org.np/ by November 29, 2019.
Applications will be accepted for one month from date of posting.
Co-founded in 1915 by Helen Keller, Helen Keller International is dedicated to saving and improving the sight and lives of the world’s vulnerable. We combat the causes and consequences of blindness, poor health and malnutrition with more than 120 programs in 19 African and Asian countries, as well as in the United States. Renowned for our reliability, efficiency and high level of technical expertise, Helen Keller promotes the development of large-scale, sustainable solutions to some of the most pressing issues in public health.
