Tenders Are Invited For International Consultant For The Revision Of The National Nutrition Policy

Tenders Are Invited For International Consultant For The Revision Of The National Nutrition Policy In Djibouti 1 BackgroundDjibouti Is A Country In The Horn Of Africa With An Estimated Population Of 965 598 Of Which About 40 Are Children Under 18 Years Of Age Significant Efforts Were Made Between 2002 And 2012 Which Led To A Reduction In Infant And Child Mortality From 127 In 2002 To 67 8 In 2012 Per 1000 Live Births Papfam 2012 Different Forms Of Malnutrition Contribute Directly Or Indirectly To Almost 35 Of All Deaths Among Children Under 5 Years Of Age According To The Results Of The 2013 Smart Survey Malnutrition Is A Major Public Health Problem In Djibouti Thus From 2010 To 2013 The Prevalence Of Global Acute Malnutrition Gam Increased From 10 To 17 8 Across The Country Gam Rates Are Above The Critical Who Threshold 15 Except For Arta And Dikhil Who Too Are Not Far From This Threshold 14 8 And 14 7 Respectively The Peak Is Reached In The Obock Region Where 25 7 Of Children Under Five Suffer From Acute Malnutrition The Phenomenon Is More Worrying In Both Urban And Rural Areas 18 6 Vs 16 8 Boys Are More Affected Than Girls 19 3 Vs 16 2 As For The Share Of Severe Acute Malnutrition Sam The Most Lethal Form The Country Has Recorded A Worrying Increase From 1 2 In 2010 To 5 7 In 2013 All Regions Of The Country Have Disturbing Rates Its Rate Varies From 2 1 In The Tadjourah Region To 6 9 In The Peri Urban Area Of Balbala In All Other Regions Of The Country Rates Exceed 3 With 5 9 In Ali Sabieh 5 7 In Obock And 4 In Arta Currently More Than 90 Of Mag Cases Have Access To Health Facilities Although The Quality Of This Care Remains A Problem The Prevalence Of Chronic Malnutrition In Djibouti Is Also Very High Reaching 29 7 Of Children Under 5 Years Old Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 More Than 90 Of Mag Cases Have Access To Health Facilities Although The Quality Of This Care Remains A Problem The Prevalence Of Chronic Malnutrition In Djibouti Is Also Very High Reaching 29 7 Of Children Under 5 Years Old Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 More Than 90 Of Mag Cases Have Access To Health Facilities Although The Quality Of This Care Remains A Problem The Prevalence Of Chronic Malnutrition In Djibouti Is Also Very High Reaching 29 7 Of Children Under 5 Years Old Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 Even If The Quality Of This Support Remains A Problem The Prevalence Of Chronic Malnutrition In Djibouti Is Also Very High Reaching 29 7 Of Children Under 5 Years Old Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 Even If The Quality Of This Support Remains A Problem The Prevalence Of Chronic Malnutrition In Djibouti Is Also Very High Reaching 29 7 Of Children Under 5 Years Old Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 Obock Is Again The Most Affected Region With 45 9 Of Children Affected But Also The Regions Of Dikhil And Tadjourah Whose Rate Exceeds The Critical Threshold Of 40 Established By The Who With Rates Of 44 2 And 40 8 Respectively For Stunting The Situation Is Much More Critical In Rural Areas Where 40 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 2 Of Children Suffer From Chronic Malnutrition Compared To 25 4 In Urban Areas Again On Average Boys Are More Affected Than Girls 32 1 Vs 27 2 2 JustificationIn Djibouti While Massive Efforts Are Under Way To Improve The Nutritional Status Of Children And Women Through A Significant Investment In The Prevention And Treatment Of Acute Malnutrition Among Pregnant Breastfeeding Women And Children Under 5 Years Of Age In Recent Years Policy Guidance In The Field Of Nutrition Is Still Very Limited In The Health Sector With Little Involvement Of Other Sectors That Are Essential In Reducing Malnutrition In The Country Although A Strategic Document Covering Actions To Address Various Forms Of Malnutrition Has Been Developed In 2018 Its Implementation Is Still In Its Infancy In Addition Normative Documents Including The National Nutrition Policy Document Developed In 2006 Does Not Reflect The Commitment Of The Government Expressed In The Vision 2035 Document Zero Hunger In The Country And Therefore Needs To Be Updated To Definitively Integrate The All National And International Recommendations To Combat Malnutrition And Also To Take Into Account The Multi Sectoral Dimension That Is Essential For Good Progress In Eliminating Hunger And Stunting In The Country As Such Unicef In Collaboration With Other Key Partners In The Fight Against Malnutrition In The Country Wfp Who Fao World Bank Usaid Was Asked By The Ministry Of Health To Support A Consultation To Revise The National Nutrition Policy 3 ObjectiveThe Overall Objective Of This Consultation Is Based On Updated Malnutrition Data In The Country To Revise Djiboutis National Nutrition Policy To Align It Not Only With The Normative Strategies And Guidance Of Who And The Global Nutrition Movement Sun At The International Level But Especially Towards A Multi Sectoral Approach Consistent With The Vision 2035 Of Zero Hunger And Zero Stunting Advocated By The Government Of Djibouti The Specific Objectives Are Identify And Analyze The Policy And Policy Environment As Well As Existing Action Plans Related To The Nutrition Of Mothers Infants And Young Children Specifically Interventions Targeting The First 1000 Days Of The Childs Life And The Cycle Of Life In General Evaluate The Effectiveness Of The Institutional And Structural Mechanisms And Mechanisms For Nutrition Coordination And Propose The Necessary Adjustments To Be Taken Into Account In The New National Nutrition Policy Examine Public Sector And Donor Investments In Interventions Targeting Nutrition Security And Their Impact On The Optimal Balance Between Specific Interventions And Nutrition Sensitive Interventions And Propose Necessary Revisions To Take Into Account Identify Opportunities Within The Different Sectors To Integrate High Impact Nutrition Interventions And Ensure Their Integration Into National Nutrition Policy 4 MethodologyThe International Consultant Should Systematically Use Normative And Generic Documents From Who Unicef And Other Reputable Scientific Agencies To Develop A National Specific Document It Will Have To Analyze The Policy Environment Governance And Coordination In The Field Of Nutrition In The Country As Well As Nutrition Planning And Budgeting Processes While Identifying Potential Gaps In Terms Of Human Resources For The Implementation Of Nutrition Interventions In The Country This Analysis Should Also Cover The Monitoring And Evaluation Aspects Of Interventions With Particular Emphasis On The Mechanisms For Collecting Analyzing And Disseminating Information In Order To Guide Decision Making In Real Time And Appropriately The Consultant Will Facilitate Multi Sectoral And Regional Consultations To Gather The Opinions And Contributions Of All Stakeholders In Nutrition In Djibouti With A

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