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Scope of work:

Background:

Bhutan has made significant strides in improving health and nutrition outcomes over recent years. The Ministry of Health, in collaboration with Ministry of Education and development partners, has implemented various nutrition programmes aimed at improving maternal, infant, child and adolescent nutrition, as well as combating malnutrition among vulnerable populations. However, several challenges persist; some micronutrient deficiencies including anemia remains a severe public health concern in children. Anaemia prevalence among children, adolescents, non-pregnant women, and pregnant women are 23%, 20.3%, 20.1% and 17% respectively that is in similar trend as 2015 anemia survey. The anemia prevalence among children is higher in rural communities (48%) compared to urban communities (38%).

The iodine deficiency disorders control programme needs to be strengthened, and micronutrient supplementation and food fortification programmes needs a thorough review. Household consumption of iodized salt has declined to 95.1% in 2023 compared to 99% in 2015. The median urinary iodine excretion among school aged children/ pregnant women has declined to 119 ug/L in 2023 from 183 ug/L in 2010.

Purpose of the assignment

The NNSAP was developed based on the data captured from MICS 2010, National Health Survey 2012 and National Anaemia survey 2015. The recent data from National Health Survey (NHS 2023) shows high level of anameia and other micronutrients needs attention to address micronutrient deficiencies through holistic multi-sectoral programme interventions. Additionally, the risk of noncommunicable disease (NCD) is also in rising trend as per the recent data from NHS 2023. There is slight increase in wasting among under five children (5.1%) in 2023 compared to 4.3% in 2015) that requires a thorough review to understand the epidemiological transitions.

Therefore, the Department of Public Health (DoPH), Ministry of Health calls for a comprehensive review of the Nutrition programmes including the review of implementation status of the National Nutrition Strategy and Action Plan (2021-2025) and make recommendations to align it with the objectives and targets of 13^th Five-Year plan of Royal Government of Bhutan (RGoB).

Objectives

The objective of this consultancy is to

• Review  the implementation of Bhutan National Nutrition Strategy and Action Plan (NNSAP 2021-2025) , including the challenges faced, and ,
• Develop NNSAP-2 (2026-2030) in alignment with the 13^th five-year plan of Royal Government of Bhutan (RGoB), UNICEF Country Programme Document (2024-2028) and findings from the National Health Survey (NHS 2023/2024).

The specific objectives include:

• Assess the relevance, efficiency, effectiveness, and impact of nutrition programme interventions including the implementation status of NNSAP (2021-2025).
• Assess the quality and coverage of delivery of nutrition specific (direct) and nutrition sensitive (indirect) interventions of NNSAP (2021-2025).
• Conduct a detailed nutrition stakeholder mapping to assess stakeholders’ engagement for implementation of current NNSAP (2021-2025) and update next NNSAP (2025-20230), and design nutrition interventions at facility to community through multi-sectoral interventions (health system, food system, education system and other relevant sectors)
• Conduct a gap/bottleneck analysis/ implementation challenges of nutrition programme including the implementation status of NNSAP (2021– 2025) and  recommend evidence based and country context specific solutions for Programme improvement.
• Review and update of the nutrition indicators in the DHIS2.
• Develop and finalize NNSAP-2 (2026-2030) to strengthen existing programmes and inform future strategies to achieve better nutrition outcomes across life course.

Methodology

The assignment will be conducted through desk review, key informants interview (KII) and focus group discussions (FGD) with identified key stakeholders meetings/ workshops representing both the national and sub-national and community levels participations including beneficiaries. The consultant will closely work with Nutrition programme of Non-Communicable Disease Division (NCDD), Department of Public Health (DoPH) of the Ministry of Health (MoH) and UNICEF.

The consultant, in consultation with the Nutrition programme unit of MoH and UNICEF, will coordinate the key informants interview (KII), focus group discussions (FGD) and stakeholders’ consultations to review the multisectoral nutrition programmer including the NNSAP 2021-2025. This consultancy will also involve travel to the selected districts and communities as per the implementation plan to carry out the assignment.

The methodology of this consultancy assignment consists of:

1. Conduct desk review on multisectoral nutrition programmes including the National Nutrition Strategy and Action Plan (NNSAP 2021-2025).

• Review existing national policies, strategies, guidelines, M&E framework, and other programme documents related to nutrition.
• Analyze relevant reports, surveys, routine nutrition programme information and studies to assess coverage of key nutrition interventions and progress in improving nutrition outcomes in Bhutan.
• Conduct situation analysis on nutrition programme design, planning, implementation, coverage and evaluation.
• Assess the current organizational structure and coordination mechanisms of multi-sectoral nutrition programmes at national, sub-national, and community levels.

2. Data collection from stakeholders’ consultations through key informants’ interview (KII), focus group discussions (FGD), stakeholders’ workshop and field visits to assess the programme coverage, relevance, efficiency, effectiveness, impact, and challenges of nutrition programme interventions including the implementation status of NNSAP (2021-2025).

• Develop tools for Key Informants Interview (KII), Focus Group Discussions (FGD), programme visits and stakeholders’ consultation to design the strategic review of multisectoral nutrition programmes including the NNSAP (2021-2025), and identify key stakeholders for KII, FGD and stakeholders’ consultations.
• Conduct interviews and consultations with multi-sectoral stakeholders, policy makers, healthcare professionals, nutrition experts, relevant multisectoral professionals/ experts, community workers and representatives from civil society organizations and international partners and beneficiaries.
• Undertake programme monitoring visits and FGDs to analyze the nutrition programme interventions including the M&E framework.
• Facilitate the stakeholder’s consultation on efficiency and effectiveness of multisectoral nutrition programmes inclusive of NNSAP (2021-2025) and made recommendations for next NNSAP-2 (2026-2030). Prepare presentation based on the desk review and interviews.
• Gather insights on programme design, implementation, challenges, gaps/ bottlenecks, and opportunities to improve efficiency and effectiveness of nutrition programme strategies and implementation coverage.

3. Conduct a comprehensive review of nutrition programme and implementation status of NNSAP (2021-2025) and recommend strategic interventions for next NNSAP-2 and develop next NNSAP-2 (2026-2030).

• Conduct a comprehensive analysis of nutrition programmes and NNSAP (2021-2025) based on the collected data, secondary data from document reviews and stakeholders’ consultations. Review exiting nutrition programme interventions, but not limited to:

• • Maternal and child nutrition interventions
  • Food fortification and supplementation programmes
  • Public awareness campaigns and behavior change communication strategies.
  • Review and update of the national nutrition strategy and action plan.
  • Nutrition M&E system

• Prepare a report and power point presentation on review of nutrition programme inclusive of NNSAP 2021-2025 review and
• Develop actionable recommendations to strengthen nutrition programmes and for next NNSAP-2 (2025-2030) with costed action plan and robust M&E framework, and develop the next NNSAP-2 92025-2030).
• Present the report on review of nutrition programme inclusive of implementation status of NNSAP (2021-2025) to UNICEF, Nutrition Programme of the Ministry of Health, and National Nutrition Task Force (NNTF).

• International consultant will work for UNICEF Bhutan in close collaboration with the Ministry of Health (MoH).  Travel to Bhutan is required for stakeholders’ consultations and present the tasks to MoH and UNICEF. Visit to health facilities, education and Monastic institutions would be required to understand the strategic interventions, gap analysis and interviews.

Work Assignments, Deliverables and Delivery Timeline:

1. Planning/ Inception report of consultancy assignment.

• Hold a pre-inception briefing meeting with UNICEF and MoH
• Develop and submit inception report and workplan with detail timeline of the assignment.

Deliverables and Delivery Deadline: Inception Report detailing the proposed methodology and work plan with timeline of the consultancy assignment submitted within 5 days contract start date.

2. Conduct desk review on multisectoral nutrition programmes including the National Nutrition Strategy and Action Plan (NNSAP 2021-2024).

• Review existing national policies, strategies, guidelines, M&E framework, and other programme documents related to nutrition.
• Analyze relevant reports, surveys, routine nutrition programme information and studies to assess coverage of key nutrition interventions and progress in improving nutrition outcomes in Bhutan.
• Conduct situation analysis on nutrition programme design, planning, implementation, coverage, and evaluation.
• Assess the current organizational structure and coordination mechanisms of multi-sectoral nutrition programmes at national, sub-national, and community levels.

Deliverables and Delivery Deadline: Draft Report with power point presentation (PPT) on (a) Desk review of situation and gap analysis of multi-sectoral nutrition programme, and (b) stakeholders mapping of multisectoral nutrition programme within 20 days of contract start date.

3. Conduct stakeholders’ consultations, key informants’ interview (KII), focus group discussions (FGD) and programme visits to assess the programme coverage, relevance, efficiency, effectiveness, impact, and challenges of nutrition programme interventions including the implementation status of NNSAP (2021-2025).

• Develop tools for Key Informants Interview (KII), Focus Group Discussions (FGD), programme visits and stakeholders’ consultation to design the strategic review of multisectoral nutrition programmes including the NNSAP (2021-2025), and identify key stakeholders for KII, FGD and stakeholders’ consultations.
• Conduct interviews and consultations with multi-sectoral stakeholders, policy makers, healthcare professionals, nutrition experts, relevant multisectoral professionals/ experts, community workers and representatives from civil society organizations and international partners and beneficiaries.
• Undertake programme monitoring visits and FGDs to analyze the nutrition programme interventions including the M&E framework.
• Facilitate the stakeholder’s consultation on efficiency and effectiveness of multisectoral nutrition programmes inclusive of NNSAP (2021-2025) and made recommendations for next NNSAP-2 (2026-2030). Prepare presentation based on the desk review and interviews.
• Gather insights on programme design, implementation, challenges, gaps/ bottlenecks, and opportunities to improve efficiency and effectiveness of nutrition programme strategies and implementation coverage.

Deliverables and Delivery Deadline: Final report with power point presentation (PPT) on (a) Key informants’ interview and FGD findings and (b) Stakeholders’ consultation on multi-sectoral nutrition programme review within 35 days of contract start date.

4. Conduct a comprehensive review of nutrition programme and implementation status of NNSAP (2021-2025) and recommend strategic interventions for next NNSAP-2 (2026-2030) based on the collected data, secondary data from document reviews and stakeholders’ consultations. Review exiting nutrition programme interventions, but not limited to:

• Maternal and child nutrition interventions

• Food fortification and supplementation programmes
• Public awareness campaigns and behavior change communication strategies.
• Review and update of the national nutrition strategy and action plan.
• Nutrition M&E system

• Prepare a report and power point presentation on review of nutrition programme inclusive of NNSAP 2021-2025 review and
• Develop actionable recommendations to strengthen nutrition programmes and for next NNSAP-2 (2026-2030) with costed action plan and robust M&E framework.
• Present the report on review of nutrition programme inclusive of implementation status of NNSAP (2021-2025)  to UNICEF, Nutrition Programme of the Ministry of Health, and National Nutrition Task Force (NNTF).

Deliverables and Delivery Deadline:

1. Final draft report on (a) strategic review on implementation of nutrition programme including the implementation status of NNSAP 2021-2025, and (b) Recommendations for costed NNSAP-2 (2026-2030) inclusive of comprehensive M&E framework within 65 days of contract start date.
2. Final report with power point presentation and all analytical documents on (a) Review of implementation status of multisectoral nutrition programmes including NNSAP 2021-2024, and (b) New NNSAP-2 (2026-2030) inclusive of comprehensive M&E framework within 120 days of contract start date.

Deliverables and payment Term

1.Inception Report detailing the proposed methodology and work plan with timeline of the consultancy assignment – 10% of contract value.

2. Draft Report with power point presentation (PPT) on (a) Desk review of situation and gap analysis of multi-sectoral nutrition programme, and implementation status of NNSAP, and (b) stakeholders mapping of multisectoral nutrition programme – 15% of contract value.

3.  Final report with power point presentation (PPT) on the findings from (a) Key informants’ interview and FGD findings and (b) Stakeholders’ consultation on multi-sectoral nutrition programme and NNSAP review – 25% of contract value.

4. Draft report on (a) strategic review on implementation of nutrition programme including the implementation status of NNSAP 2021-2025, and (b) Draft NNSAP-2 (2026-2030) with Recommendations for costed NNSAP-2 (2026-2030) inclusive of comprehensive M&E framework –  30% of contract value.

5.  Final report with power point presentation and all analytical documents on (a) Review of implementation status of multisectoral nutrition programmes including NNSAP 2021-2024, and (b) Final NNSAP-2 (2026-2030) with Recommendations for costed NNSAP-2 (2026-2030) inclusive of comprehensive M&E framework – 20% of contract value.

To qualify as an advocate for every child you will have…

Minimum Qualification: Masters degree in public health and nutrition/health and nutrition policy system/social sciences/ or any relevant fields.

Knowledge/Expertise/Skills required:

• Extensive work experience (at least 10 years) in conducting review and evaluations and of nutrition programmes, nutrition programme design, action plan and developing national strategies at national and internation al levels preferably in South Asia.
• Demonstrated technical knowledge on Primary Health Care and Nutrition programmes.
• Strong analytical skills and experience in qualitative and quantitative research methods.
• Excellent writing and communication skills in English. Excellent writing skills and ability to synthesize complex information and issues. Strong analytical and conceptual thinking, ability to work in teams.
• Ability to organize and plan complex work following the established timeframes.
• Demonstrated communication, analytical and facilitation skills, and able to manage diverse viewpoints and work in demanding situations; Experience in liaising with public officials and facilitating discussions among diverse stakeholders.
• Familiarity with Bhutanese context and nutrition landscape is highly desirable.
• Experience of working with UN, especially UNICEF, WFP, and WHO, and international nutrition agencies/ organizations/ academia  on similar assignments will be an asset.
• The consultant will be required to maintain strict confidentiality regarding all information obtained during the assignment.

For every Child, you demonstrate…

UNICEF’s values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

To view our competency framework, please visit  here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks: 

1. A financial proposal should be submitted along with the application. Application without the financial proposal will not be considered.

2. Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

3. Selected consultants/individual must complete the mandatory UNICEF online courses prior to signing contract (Prevention of Sexual Harassment and Abuse of Authority (PSHAA), Sexual Exploitation Abuse (PSEA), Ethics and Integrity at UNICEF and others as applicable).

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.