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Request for Proposals

Assessing the Landscape in the


Procurement, Provision and
Utilization of Zinc/ORS to Treat
Childhood Diarrhoea in Selected
Asian Countries

Issued by Nutrition International

Deadline for receipt of proposals:

July 10, 2018


11:59 PM EST Ottawa Time

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Table of Content

Request for Proposal Notice ................................................................................................ 3


Background .................................................................................................................................................... 3
General instructions and considerations ..................................................................................................... 3
Conflict of Interest......................................................................................................................................... 3
General Disclosures ....................................................................................................................................... 3
Submission of proposal ................................................................................................................................. 4
Cover-Letter and Declaration ........................................................................................................................ 4
Profile ..............................................................................................................................................................5
Submission ......................................................................................................................................................5
Receipt, Evaluation and Handling of Proposals ...........................................................................................5
Selection criteria ............................................................................................................................................ 6
PART I: Background Information on NI’s Zinc & ORS Programs ......................................... 7
Overall objective of the Zinc & LO-ORS Programs ...................................................................................... 8
Specific objectives of the Zinc & LO-ORS Programs .................................................................................... 8
Project locations ............................................................................................................................................ 8
PART II: Details of the Situational Assessment....................................................................9
Background & Rationale of the Situational Assessment ............................................................................. 9
Overall objectives of the Situational Assessment ........................................................................................ 9
Specific Objectives of the Situational Assessment ...................................................................................... 9
Scope .............................................................................................................................................................10
Methodology and Data .................................................................................................................................10
Activities and deliverables ...........................................................................................................................10
Timeline ........................................................................................................................................................ 12
Annex A. Project Implementation Plan and Timetable ................................................. 13

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Request for Proposal Notice
Nutrition International (formerly the Micronutrient Initiative), an international NGO dedicated
to improving nutrition around the world, invites proposals from competent Consultants or
Agencies for conducting an Situational Assessment of the current landscape in the provision
and utilization of zinc supplements and Low-Osmolarity Oral Rehydration Salts (LO-ORS) to
treat diarrhoea in children under five years of age through both the public and private sector in
countries in Asia where Nutrition International currently operates.

Background
The explicit primary objective of Nutrition International’s (NI’s) Zinc & LO-ORS Programs is to
reduce diarrhoea-caused mortality in children under five by increasing the number of episodes
of uncomplicated childhood diarrhoea are treated with zinc and LO-ORS as per global and
national guidelines. While NI has offices and program support in Bangladesh, India, Indonesia,
Pakistan and the Philippines, NI’s support to diarrhoea management in the Asia region is
currently limited to the public sector in Indonesia, Pakistan and Bangladesh. All three programs
are in the scale-up phase and continue to work on improving monitoring systems, addressing
supply chain barriers and improving care seeking by caregivers for their child’s diarrhoea
NI is planning this situational assessment to evaluate the current landscape in the procurement,
provision and utilization of zinc supplements to treat diarrhoea in children under five years of
age through both the public and private sector in all countries in Asia where NI currently
operates to guide in the design of its future global strategy for Zinc and LO-ORS interventions.

General instructions and considerations


 These instructions should be read in conjunction with information contained in the enclosed
Terms of Reference (ToR), and in any accompanying documents within this package.
 NI is not bound to accept the lowest priced, or any, proposal. NI reserves the right to request
any (or all) Respondent(s) to meet with the NI to clarify their proposal(s) without
commitment, and to publish on its website answers to any questions raised by any
Respondent (without identifying that Respondent).
Conflict of Interest
 Respondents must disclose in their proposal details of any circumstances, including
personal, financial and business activities that will, or might, give rise to a conflict of
interest. This disclosure must extend to all personnel proposed to undertake the work.
 Where Respondents identify any potential conflicts they must state how they intend to
avoid any impact arising from such conflicts. NI reserves the right to reject any proposals
which, in NI’s opinion, give rise, or could potentially give rise to, a conflict of interest.
General Disclosures
Respondents must disclose:
 If they are or have been the subject of any proceedings or other arrangements relating to
bankruptcy, insolvency or the financial standing of the Respondent including but not
limited to the appointment of any officer such as a receiver in relation to the Respondent
personal or business matters or an arrangement with creditors or of any other similar
proceedings.
 If they have been convicted of, or are the subject of any proceedings, relating to:

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o Criminal offence or other offence, a serious offence involving the activities of a


criminal organization or found by any regulator or professional body to have
committed professional misconduct.
o Corruption including the offer or receipt of any inducement of any kind in relation
to obtaining any contract, with the NI, or any other contracting body or authority.
o Failure to fulfil any obligations in any jurisdiction relating to the payment of taxes.
Submission of proposal
The consultant is expected to submit a proposal (ideally not more than fifteen pages – excluding
Annexes, resume, previous reports, timeline, and the financial proposal) which should have the
following outline:
Part 1: A Technical implementation plan (maximum 10 pages) detailing:
 Rationale and Context for the Situational Assessment.
 Overall Objective and Specific Objectives– describing the way the Respondent will ensure
rigor in measurement and data collection.
 Methodology: The Respondent shall provide a detailed methodology. The Respondent shall
provide details on:
o Data and Methods: What type of data will be needed and what methods will be
used to obtain the data.
o Data tools: What types of data collection instruments will be used and how to
develop them.
o Indicators/topics: Potential qualitative topics that will be measured (and if
possible the quantitative indicators).
o Other Data: reports and documents that will be needed to learn how each element
of the project implementation model was implemented (inputs, activities, outputs
and outcomes.
o Analysis: Detail the data analysis methods that will be used.

Part 2: Qualifications: Respondent’s previous situational assessments and/or relative


research. This shall include:
 Resume of the Respondent (up to 4 pages)
 A sample of previous situational assessment or research produced.

Part 3: Plan with a timeline: Timeline for the Situational Assessment which includes
specific deadlines for each of the implementation activities, milestones and deliverables for
the assessment’s phases, including: data collection, data analysis, findings, interpretation of
results, preliminary report, and final report.

Part 4: Financial Proposal: the Respondent shall submit a Financial Proposal detailing:
 Breakup of all activities, outputs and deliverables (Annex A).
 Estimated cost disaggregated by the number of days the consultant will be working.
 All amounts need to be quoted in Canadian Dollar (CAD).

Part 5: Annexes (no page limit)

Cover-Letter and Declaration


 Proposals must be accompanied by a covering letter (1 page) showing address of the
Respondent. The letter must be signed and quote the RfP title.

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Profile
Respondents who are interested in submitting a proposal to conduct this Situational
Assessment should have:
 At least five years of experience with in child survival, and/or public health, with emphasis
on interventions and/or programs that focus on the treatment of diarrhoea with Zinc and
LO-ORS, including a robust understanding of the public and private supply chains.
 Experience conducting Situational Assessments or other types of research in child survival,
with emphasis on interventions and/or programs similar to those that focus on the
treatment of diarrhoea with Zinc and LO-ORS.
 At least five years of experience in collecting and analyzing quantitative and qualitative data.
 Language skills: Speaking and writing English
 Familiarity with the context of the countries in Asia where NI currently has programs that
the situational assessment will focus on, especially with regard to the landscape of the
private sector.

Submission
The technical and financial proposals shall be put into a covering E-mail specifically indicating
with subject line ‘Multi-country Situational Assessment: Zinc and ORS’

Proposals need to be sent to:

Daniel Lopez de Romana (Email: dlopezderomana@NutritionIntl.org) OR

Ambica Gambhir (Email: agambhir@NUTRITIONINTL.ORG)

 Proposals must be submitted in English.


 Only E-mail bids will be accepted. Only those short-listed will receive an acknowledgment.
 Late proposals will not be accepted in any circumstances. Proposals received after the due
date and time will not be considered.

Receipt, Evaluation and Handling of Proposals


Once a proposal is received before the due date and time, NI will:
 Log the receipt of the proposals.
 Review all proposals and disqualify any non-responsive ones (that fail to meet the terms set
out in these instructions), and retain the Respondents details on file with a note indicating
disqualification.
 Evaluate all responsive proposals objectively in line with the criteria specified below and
inform respondents of the evaluation decision being made within seven (7) business days.

NI reserves the right to:


 Accept or reject any and all proposals, and/or to annul the RfP process, prior to award,
without thereby incurring any liability to the affected Respondents or any obligation to
inform the affected respondents of the grounds for NI's actions prior to contract award.
 Negotiate - with Respondent(s) invited to negotiate - the proposed technical approach
and methodology, and the proposed price based on the Respondent’s proposals.

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 Amend this RFP at any time.

Selection criteria
Submitted proposals will be shortlisted and then successful proposals will be identified based
on the below selection criteria (See Table 1). Successful Respondent will contacted and will be
expected to enter into a Contract with NI for the duration of the Work. The terms and conditions
of this current RfP will normally form part of the Contract.

Table 1: Proposal Scoring Criteria


Item Assessment Category: Technical Proposal Weight
Proposal The rational, context, and objectives, reflects the requirements of this task 10%
and are adequately described
The study methodology, data collection mechanisms, and data analysis plan 20%
are plausible to achieve the objectives of the study. The proposal lists the
types of reports and documents that will be needed for the different
components of the study
The proposal includes a clear and reasonable timeline (with potential 10%
adjustment for delays); the time line includes specific deadlines for each of
the implementation activities, milestones and deliverables is
Profile A sample of the previous work and its similarity to the assignments of this RfP 10%
The required qualifications and key competencies (education and work 10%
experience) to carry out the assignment are met by the team members (as
per their presented resumes)
The proposed summary of the roles and responsibility of each team member 5%
and its relevant competences
Budget Budget: The financial proposal capture all critical components, various 20%
expenses, and justification summaries
Budget: The estimated expenses and the administration cost in the proposed 15%
budget are reasonable for each of the activities
TOTAL 100

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TERMS OF REFERENCE
PART I: Background Information on NI’s Zinc & ORS
Programs

Treatment of Diarrhoea with Zinc and ORS


Diarrhoea continues to be a leading cause of childhood death. The latest estimates on child
mortality by the UN Inter-agency Group for Child Mortality Estimation for 2016 show that 8%
of all child deaths under five years of age remain due to diarrhoea1. In the post-neonatal period,
this is second only to pneumonia, and equivalent to malaria and HIV/AIDS combined. This
translates to over 1,200 young children dying each day, or over 400,000 children a year. There
has been a downward shift from 15% in 2008 that can be attributed to improved vaccine
coverage, the scale up of zinc and LO-ORS treatment, and improvements in the rates of
exclusive breastfeeding2.

Zinc and ORS are critical in the treatment of childhood diarrhoea. Zinc, when combined with
ORS, has been shown to reduce the duration and severity of childhood diarrhoea in zinc
deficient populations3, and thus contribute to averting child deaths. An estimated 90% of deaths
due to acute watery diarrhoea may be prevented through the use of ORS4 and treatment with
zinc is estimated to decrease diarrhoea mortality by 23%3. Therefore, the World Health
Organization (WHO) recommends the use of zinc and ORS treatment in addition to other
measures for the clinical management of acute diarrhoea.

NI’s Zinc & LO-ORS Programs


NI’s Zinc & LO-ORS Programs are in place in the most affected global regions. In Africa, current
programs are building upon the successes of DFATD’s previous grant, which introduced and
scaled-up the use of zinc and LO-ORS as the first-line treatment of childhood diarrhoea,
primarily in the public sector through facility-based IMCI and the community outreach of iCCM.
Under the previous grant, the country programs focused on ensuring systems were in place,
such as: a strong enabling environment by improving policies, guidelines, and procurement
practices; improved public sector service delivery capacity; and improved treatment seeking
among caregivers. Current programs are now focused on sustaining the coverage and capacity
gains made under the previous grant, and will focus more on improving care seeking for
childhood diarrhoea. In addition, NI is working with the private sector to increase the supply
of co-packs of Zinc & LO-ORS, especially at the community level. In Asia, the approach is very

1 United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & Trends in Child Mortality:
Report 2017, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation’, United Nations
Children’s Fund, New York, 2017
2 Pneumonia and Diarrhoea Progress Report 2015: Sustainable Progress in the Post-2015 Era. International Vaccine

Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, 2015.
3 Fischer Walker CL, Black RE. Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and

incidence of future episodes. International Journal of Epidemiology, 2010, 39 (Suppl 1):i63-i69.


4 Munos MK, Walker CL, Black RE. The effect of oral rehydration solution and recommended home fluids on diarrhoea

mortality. Int J Epidemiol. 2010 Apr; 39 Suppl 1:i75-87.

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similar and the programs build upon lessons learned in the demonstration phase of each of the
country programs. NI’s support in Indonesia, Pakistan and Bangladesh is in the scale-up phase
and continues to work on improving monitoring systems, addressing supply chain barriers and
improving care seeking by caregivers for their child’s diarrhoea.

Overall objective of the Zinc & LO-ORS Programs

The explicit primary objective of NI’s Zinc & LO-ORS Programs is to reduce diarrhea-caused
mortality among children under five.

Specific objectives of the Zinc & LO-ORS Programs

The specific objectives of the ZINC & LO-ORS Programs are as follows:
1. To improve the enabling environment for program scale-up, through the support to
public sector policy makers to improve the leadership and coordination of the scale-up of zinc
and LO-ORS, which includes support for improving alignment of policies with international
best practice, national scale-up plans, product standards, and advocacy for increased budget
allocations.
2. Improve the provision of zinc and related health services, through the support to public,
private and civil society sectors to improve the quantity, quality and timeliness of zinc and ORS
provision as frontline treatment for uncomplicated diarrhoea, and provide appropriate
counselling to caregivers, which includes support for policy development for importing or
manufacturing zinc, development of guidelines for front line health workers, and training health
facility staff and CHWs.
3. Increase the demand and use of zinc and ORS by caregivers through the conduction of
formative research and the support to governmental partners in the development and
implementation of behavior change strategies, targeted for providers and caregivers within, and
accessing, both public and private health sectors.
4. Demonstrate, scale and sustain programs. NI has applied a tailored approach for each
country, and more broadly, each region.

Project locations
The geographical scope of the situation assessment will include Bangladesh, Indonesia,
Pakistan, and select states of India.

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PART II: Details of the Situational Assessment


Background & Rationale of the Situational Assessment
The purpose of performing this multi-country situational assessment is to assess the current
landscape in the procurement, provision and utilization of zinc supplements to treat diarrhea
in children 6-59 months of age through both the public and private sector in all countries in
Asia (Bangladesh, India, Indonesia, and Pakistan) where NI currently operates Zinc and LO-
ORS programs.

This multi-country situational analysis is necessary to guide NI in the design of its future global
strategy for zinc interventions by understanding current barriers and opportunities to the
treatment of childhood diarrhea with zinc and LO-ORS through both the public and private
sector and understanding who are the stakeholders at national and regional level currently
involved in zinc and LO-ORS interventions.

Overall objectives of the Situational Assessment

The overall objectives of this Multi-country situational Assessment is to:


1. Assess the current landscape at national and subnational levels for the
procurement, provision and utilization of zinc supplements and LO-ORS to treat
diarrhea in children under five years of age through the public sector, including,
but not limited to, current policies and guidelines, platforms for delivery, and
supply chain, products available, care-seeking behavior and access to and use of
zinc supplements and LO-ORS through the public sector.

2. Assess the current landscape at national and subnational levels for the provision
and utilization of zinc supplements and LO-ORS to treat diarrhea in children under
five years of age through the private sector, including, but not limited to, the
description of current actors, level of participation in the market, platforms for
delivery, and supply chain, products available, current sales, care-seeking
behavior and access to and use of zinc supplements and LO-ORS through the
private sector (private facilities (for profit or non for profit), pharmacies,
shops/outlets, etc.

3. Assess the current landscape at national and regional level of stakeholders (i.e.
international agencies, international and national NGOs, professional bodies, etc.)
involved in zinc and LO-ORS programs.

Specific Objectives of the Situational Assessment


Objective 1: Describe the current landscape for each country with regard to barriers in the
enabling environment to the provision of zinc supplements and LO-ORS to treat
diarrhea in children under five years of age.
Objective 2: Describe barriers and opportunities with regard to caregiver’s knowledge, care-
seeking behavior, access and use of zinc supplements and LO-ORS for the
treatment of childhood diarrhea within each country.

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Objective 3: Describe the platforms for delivery, supply chain and products available through
the public sector and current barriers to the access of zinc supplements and LO-
ORS through the public sector.
Objective 4: Describe current actors, level of participation in the market, platforms for delivery
and supply chain, current sales and products available through the private sector
and current barriers to the access of zinc supplements and LO-ORS through the
private sector.
Objective 5: Describe the current landscape at national, regional and global level of stakeholders
(i.e. international agencies, international and national NGOs, professional bodies,
etc.) involved in zinc and LO-ORS programs.
Objective 6: Provide overall conclusions with regard to:
a. Current situation at national level for the procurement, provision and
utilization of zinc supplements and ORS to treat diarrhea in children 6-59
months of age through the public sector.
b. Current situation at national level for the provision and utilization of zinc
supplements and ORS to treat diarrhea in children 6-59 months of age
through the private sector.
c. Current situation at national, regional and global level of stakeholders
involved in zinc and ORS programs

Scope
The Multi-country Situational Assessment will cover 4 countries in Asia (Bangladesh,
Indonesia, Pakistan and select States of India) where NI currently operates.

Methodology and Data


The consultant will suggest the methodology that will be used to conduct the Multi-country
Situational Assessment, including an analytical framework, a strategy for collecting and
analyzing data, specifically designed tools, and a detailed work plan that will allow to assess
the project achievements, adequacy of guidance and technical support, challenges and needs
to fulfill project objectives, etc.

Activities and deliverables


The selected Consultant will carry out the following activities:
1. Draft Proposal
Activity 1. The consultant will prepare a draft proposal based on the objectives of the Multi-
country Situational Assessment, including the proposed methodology and budget.
Deliverable (1): Draft proposal for Multi-country Situational Assessment with timeline and
budget.

2. Preparatory Phase

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Activity 2. Inception meeting: Meeting between Consultant and NI staff remotely to discuss
and finalize the design of the Multi-country Situational Assessment.
Deliverable 1: Final version of the proposal for the Multi-country Situational Assessment.

Activity 3. Desk Review and Key Informant Interviews (KII): Review of all relevant
documentation, including, but not limited to, demographic surveys, nutrition surveys,
epidemiological surveys, national program reports, reports from international agencies and/or
NGOs, reports from local NGOs, reports from the private sector, and scientific research
studies with regard to the procurement, provision and utilization of zinc supplements to treat
diarrhea in children under five years of age through both the public and private sector in all
countries where NI currently is operating Zinc & LO-ORS Programs. NI and the consultant
will develop a list of key country-level and global-level informants. The consultant will also
develop specific questionnaires adapted to each category of stakeholders
(manufacturers/suppliers, NGO, MOH, etc.) and administer them by phone or email.
In addition, development of a well-organized online repository of documents and tools
relevant to the scope of NI’s Zinc & LO-ORS Programs in Asia should be undertaken.
Deliverable 2: Report that summarizes and includes conclusions of the Desk Review.
Online repository of documents and tools relevant to the scope of the Zinc & LO-ORS
Programs in Asia.

3. Field Work
Activity 4. Travel to two countries where NI currently operates to interview key actors (NI
staff, government, partners, professional bodies, private sector, etc.), collect complementary
documentation and visit project implementation areas.
Deliverable 3. Report on travel to countries.

4. Analysis and Reporting


Activity 5. Analyze and triangulate all information collected during desk review and field work
and prepare draft report of Multi-country Situational Assessment that:
1. Describes the current landscape for each country with regard to barriers in the
enabling environment to the provision of zinc supplements and LO-ORS to treat
diarrhea in children under five years of age.
2. Describes the barriers and opportunities with regard to caregiver’s knowledge,
care-seeking behavior, access and use of zinc supplements and LO-ORS for the
treatment of childhood diarrhea within each country.
3. Describes the platforms for delivery, supply chain and products available through
the public sector and current barriers to the access of zinc supplements and LO-
ORS through the public sector.
4. Describes the current actors, level of participation in the market, platforms for
delivery and supply chain, current sales and products available through the private
sector and current barriers to the access of zinc supplements and LO-ORS through
the private sector.

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5. Describes the current landscape at national, regional and global level of


stakeholders (i.e. international agencies, international and national NGOs,
professional bodies, etc.) involved in zinc and LO-ORS programs.
6. Provides overall conclusions with regard to:
a. Current situation at national level for the procurement, provision and
utilization of zinc supplements and ORS to treat diarrhea in children under five
years of age through the public sector.
b. Current situation at national level for the provision and utilization of zinc
supplements and ORS to treat diarrhea in children under five years of age
through the private sector.
c. Current situation at national, regional and global level of stakeholders involved
in zinc and ORS programs.

Deliverable 4. Draft report of Multi-country Situational Assessment.


Deliverable 5. Final report of Multi-country Situational Assessment that includes feedback
from NI.

The report of the Multi-country Situational Assessment should include:


• Table of Contents
• List of Acronyms
• List of Tables
• List of Figures
• Executive Summary
• Introduction
• Methodology
• Main findings and analysis
• Conclusions
• Annexes

Timeline
The Situational Assessment is expected to be conducted in three months between July and
September 2018. All activities, including data collection, analysis and a summary report need
to be finalized before the end of September 2018. Ideally, the report that summarizes the
conclusions of the Desk Review (Deliverable 2) will need to be finalized by August 24, 2018.

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Annex A. Project Implementation Plan and Timetable

Activities Deliverables July August September

W1 W2 W3 W4 W1 W2 W3 W4 W1 W2 W3 W4

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