Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents around the world — government officials, civil society leaders and social innovators — to create strong systems that support healthy, educated people. We help our partners move from knowing their goal to knowing how to reach it. We combine global expertise in health, education and nutrition with analytic rigor, practical support for decision-making and implementation and access to peer problem-solving networks. Together with our partners, we build self-sustaining systems that serve everyone and deliver lasting results. Then we share what we learn so others can achieve results for development, too.
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1.1 Multiple Micronutrient Supplement Project Overview
Micronutrient deficiencies and malnutrition in pregnant women contribute to poor pregnancy outcomes such as low birth weight, small for gestational age, and preterm births.
1. Supplementation of iron and folic acid (IFA) has been recommended by the World Health Organization (WHO) to be included in antenatal care (ANC) programs, for the prevention of anemia.
2. However, multiple micronutrient supplements (MMS) have proven to be a more cost-effective option that provides both IFA and additional micronutrients.
The “Market Shaping for Multiple Micronutrient Supplement (MMS)” project funded by the Bill and Melinda Gates Foundation aims to build a holistic market shaping strategy for the introduction and scale-up of MMS in Ethiopia. This project will articulate co-created and holistic strategies for Ethiopia, including an evidence and advocacy roadmap, which will be comprised of evidence strategy and demand generation and advocacy strategy/roadmap. The evidence and advocacy roadmap will outline tactics for generating and applying evidence for decision-making, demand generation, and advocacy. The project will also collaboratively co-create a market shaping roadmap grounded in the four market enabling factors: regulatory, financing, supply, demand.
2. The Opportunity
R4D is looking for a consultant, based in Ethiopia, with proven experience in Social Behavioral Change Communication (SBCC) in Ethiopia, to support the R4D team to undertake SBCC assessment and demand generation and advocacy strategy development for the introduction and scale-up of MMS. The consultant will work closely with the R4D team as well as another evidence-generation consultant.
2.1 Duties and Responsibilities
- Working closely with the R4D team, the consultant will:
I. Undertake desk review of available program experiences and literature to generate evidence on critical demand-side barriers and factors to MMS uptake and adherence
- Synthesize various market landscapes which have been completed by different partners globally and in Ethiopia around MMS demand generation and advocacy.
- Based on experiences from Iron Folic Acid (IFA) supplementation or recent/ongoing MMS operational research synthesize evidence on factors that influence uptake and adherence of ANC supplementation with a focus on pregnant women and their families, the wider community, and service providers
- Based on SBCC of IFA or other ANC supplementation experiences or SBCC of MMS from recent or ongoing operational research synthesize factors like feasibility, impact, sustainability, and relative costs of the different SBCC channels to reach the different segments of target audiences to increase demand and adherence of MMS in different geographic and socio-cultural contexts
II. Conduct In depth Interviews (IIs) and Focus Group Discussions (FGDs) with end users, Key Opinion Leaders (KOLs) and selected segments of service providers (supervisors, managers, Health Extension Workers - HEWs, ANC service providers at health center and primary hospitals in different geographies such as urban, rural, agrarian and pastoralist) to:
- Identify where advocacy is most needed (i.e., what groups of stakeholders—i.e., regulators, payors—are within their sphere of influence and not yet bought into MMS) and draw on principles from political economy analysis to inform the strategy based on their power and influence.
- Identify key factors impacting awareness, demand and adherence for ANC supplementation in general, as well as considerations around switching demand from IFA to MMS?
- Explore ways to reach the relevant segments of healthcare workers, supervisors, and managers to increase their knowledge on MMS supplementation, and to increase their counseling skills
- Explore ways to reach PWs and their families, and the wider community (SBCC channels)
- Capture perspectives on factors like feasibility, impact, sustainability, and relative costs of the different SBCC channels to reach various segments of target audiences (with a focus to service providers and their supervisors / managers, pregnant women and their families and the wider community)
III. Develop an evidence-informed advocacy and SBCC strategy that guides IFA transition to MMS in Ethiopia
- Based on the analysis of information through desk review, IIs and FGDs, provide recommendations on strategic aspects to be addressed through MMS SBCC strategy and advocacy strategy to achieve IFA transition and high coverage and adherence of MMS to ensure the desired biological impact of MMS in Ethiopia.
- Formulate evidence-informed SBCC strategy including a M&E plan through a co-creation process including narration of the most feasible SBCC channels and key messages for each intended audience (service providers and their supervisors, pregnant women and their families, and the wider community) with a focus on uptake and adherence.
- As part of the SBCC strategy, highlight challenges, risks and assumptions envisioned to have the potential to affect MMS SBCC activities implementation and consequently hinder the long-term adoption of practices
- Develop an evidence-informed Advocacy Strategy with clear advocacy actions and messages targeting key policy / decision leaders and managers at federal and regional levels including an advocacy narrative to create a dossier of evidence for MMS champions, stakeholders' role and responsibility matrix and implementation plan.
2.2 Deliverables
- Illustrative/expected deliverables include the following:
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Detailed work plan, expected within 1 week from the date of signing of the contract
- An assessment report reflecting recommendations on strategic aspects to be addressed through SBCC strategy and advocacy strategy (based on desk reviews and key informant interviews/consultations with stakeholders). The report should include:
- Gaps and key focus areas that could be addressed through advocacy
- Gaps in existing nutrition policies, plans, and government commitments, and key thrust areas that could be addressed through advocacy
- Ongoing/planned advocacy efforts and mandates of different partners for consolidation and better alignment of MMS actions
- Stakeholder mapping consisting of potential allies, key influencers, and target audience for nutrition advocacy
- A robust SBCC strategy and advocacy strategy for MMS, to include: advocacy actions, specific messages, implementation roadmap/modalities (short-term with quick wins and long-term), stakeholders’ roles and responsibilities matrix, monitoring and evaluation framework, and budget plan
2.3 Required Qualifications
Results for Development is an EOE/M/F/Vet/Disabled/Affirmative Action Employer committed to fostering
and nurturing an energetic, collaborative and diverse workforce. R4D provides market-competitive salaries and comprehensive employee benefits.