CARE ETHIOPIA
|
Qualitative Research Assessment |
Growing Nutrition for Mothers and Children (GROW) |
April 2017 |
Qualitative Research Assessment for East and West Hararghe, and Afar
In recent years, Ethiopia has experienced rapid economic growth, yet this growth has not translated into improvements in basic living conditions for the region’s poor and rural populations, particularly women, girls and boys. While the number of chronically malnourished people has declined worldwide, change has been slow in Ethiopia where hunger and malnutrition persist. Poor nutrition during a child's first 1000 days, from pregnancy through to a child's second birthday, can cause irrevocable health and development consequences throughout the child’s life. Poor nutrition in women of reproductive age and during pregnancy not only affects child health outcomes, but has severe consequences for maternal morbidity and mortality.
Underlying causes of malnutrition in Ethiopia include:
a) Lack of access to sufficient and nutritious food (many families are unable to acquire sufficient food and intra-household consumption is unbalanced)
b) Lack of appropriate care and limited knowledge of nutrition (certain practices have a negative impact on nutrition)
c) Lack of basic health, water and sanitation services (leading to diseases which increase malnutrition rates)
The 2014 Ethiopian Demographic Health Mini-Survey found that 40% of children under 5 suffered from stunting, the result of long-term chronic malnutrition, and 9% suffered from wasting, the result of acute malnutrition. Although Ethiopia has made encouraging progress in recent years in detecting and managing acute malnutrition, there is growing evidence that a more integrated approach is required to tackle the underlying causes.
The Growing Nutrition for Mothers and Children (GROW) project, funded by the Government of Canada, aims to improve the nutritional status of women of reproductive age (15-49 years) and children under 5 years in the Oromia Region, in East Hararghe, West Hararghe, and Afar.
The goal of the GROW project is to improve the nutritional status of women of reproductive age and boys and girls under 5 in Ethiopia.
The project has three intermediate outcomes:
1) Improve nutrition practices and services for women of reproductive age and boys and girls under 5
2) Improve nutrition sensitive practices for women of reproductive age and boys and girls under 5and
3) Strengthen governance of gender-sensitive nutrition programs and approaches at the Federal, Regional, Zonal and Woreda levels.
The project will be implemented between April 2016 and March 2020. It is led and implemented by CARE and includes implementing partners such as McGill University, Cuso International, and the Interagency Coalition on AIDS and Development (ICAD). Working with relevant government ministries is also an integral part of this project. GROW is a scale up of CARE’s successful project Improving Health and nutrition of Vulnerable Women and Children in Ethiopia and Zimbabwe (2012 – 2014) funded through the Muskoka Initiative Partnership Program.
CARE conducted a quantitative baseline study in Ethiopia in October 2016. This study was a household survey looking at access to food, food preservation and storage, feeding practices (including infant and young child feeding), women’s and men’s diet diversity, women’s empowerment, access to health and nutrition services, health status (i.e. diarrhea incidents in children), water sources, sanitation facilities and hygiene practices. The study also included anthropometric measurements, which included the length, weight, and age of children, and the mid-upper arm circumference (MUAC) of women of reproductive age to assess nutritional status.
To complement the quantitative study, CARE seeks to conduct a qualitative research assessment in the same regions of Ethiopia in order to generate in-depth data on knowledge, attitudes and practices around nutrition, feeding practices, gender equality and women’s empowerment. A formative assessment at the beginning stages of GROW will be crucial in understanding gender dynamics in project locations and will inform a gender sensitive behaviour change communication framework within which CARE delivers its key nutrition and gender interventions. With a large component of the project focusing on transformation of social norms, the success of the project is largely dependent on an accurate and context-specific understanding of these issues. The baseline results will also feed into the project’s learning and research agenda, contributing towards identifying specific research projects. The data collection for this work will be conducted in collaboration with an international (Canadian) and local consultant.
The objectives of the qualitative research study are to:
1. Provide local context-specific details on knowledge, attitudes and practices related to nutrition practices and gender equality / women’s empowerment. Specifically, the study will identify decision-making processes, barriers, support and challenges related to:
· Knowledge of nutrition and feeding practices
· Breastfeeding
· Complementary feeding and weaning
· Maternal nutrition
· Preparation and consumption of food
· Adaptations during times of food shortage
· Control of resources
· Quality of services (health, nutrition, hygiene)
2. Describe the current state of gender dynamics in the project locations, highlighting the most significant gender issues which impact on the nutritional status of women of reproductive age and children under 5 and which are likely to impact on the intended results (outcomes) of the project, and identify the processes and factors that influence (enable or disable) transformation in behaviour change in these areas (such as intra-household dynamics).
3. Suggest how women’s empowerment and men’s engagement can be defined and measured in regards to nutrition-specific practices and the project outcomes.
· Photovoice[1]/focus group discussions with women of reproductive age with one or more living children under 5 years of age, who have lived in the community for one year, and who have a living mother-in-law in the community
· Separate focus group discussions with husbands (or eldest son aged 18 or older living at home if there is no husband) of these same women (marital networks) using tools, techniques or questions to elicit more detailed responses
· Separate focus group discussions with mothers-in-law of these same women (marital networks) using tools, techniques or questions to elicit more detailed responses
· Interviews with community, religious, and political leaders (including members of Nutrition Coordinating Committees (NCC) as applicable) using tools, techniques or questions to elicit more detailed responses.
Table 1: Data Collection
| East Hararghe Zone | West Hararghe Zone | Afar | Total (per method) |
FGDs (using Photovoice) with women | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 3 (N=18) |
FGDs (marital network) with male partners of the women above (or eldest son) | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 3 (N=18) |
FGDs (marital network) with mother-in-laws of the women above | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 1 (N=6 per FGD) | 3 (N=18) |
Interviews with community/religious leaders | 3 | 3 | 3 | 9 |
TOTAL | 9 focus groups (54 people) and 9 interviews |
The applicant is required to meet the following deliverables:
6 Timeline & Consultancy Duration
Applicants for this study should submit a work plan and timetable which allows for the deliverables outlined below to be achieved in line with the dates specified.
Item | Draft Timeline |
Pilot test data collection tools in collaboration with Canadian consultant | May 2017 |
Field report from the data collection experience | June 2017 |
Moderator/Facilitator Training in collaboration with CARE and Canadian consultant | June 2017 |
Data collection in collaboration with Canadian consultant | June 2017 |
Data cleaning, transcriptions (verbatim) and translation into English | June 2017 |
Submission of raw data in both English and local language(s) to CARE | June 2017 |
On-site report of observations, limitations, and lessons learned | June 2017 |
Key deliverables will be linked to a payment schedule. Full payment will not be provided until submission of all deliverables.
Consultant and Research Facilitators/Moderators
Number required | · One local consultant to work in collaboration with Canadian consultant · Minimum of four facilitators/moderators (two female, two male) |
Responsibilities | · Review draft tools and consent forms · Translate tools in to local language(s) (FGD, survey, consent forms and interview guide) · Support CARE with the preparation and completion of ethics application as required · Support translation of the ethics application as required · Work with CARE to identify the best way of recruiting participants for focus groups and interviews and a process for obtaining informed consent from all participants prior to data collection · Support CARE with logistical planning for transportation, locations for FGD and KII, and refreshments for participants · Pilot and review tools as per process outlined in piloting document · Participate in training by Canadian consultant on: qualitative data collection, ethical considerations / consent, FGD guides/interview guides, practice applying the guides · Travel to and from data collection site · Facilitate FGDs and interviews · Record FGDs and interviews · Transcribe interviews and FGDs verbatim (not a summary) · Translate into English · Provide regular updates to CARE or Canadian consultant · Keep receipts for all pre-approved expenses in line with organisational procedures in case of audit. · Participate in a debriefing session with CARE highlighting the main findings from the research study |
The total budget available for this Assignment is $11,665 CAD, which includes ALL costs related to this assignment. Financial proposals should include:
The interested consultant should have a long history of experience in public health and nutrition with preferred background and experience in gender and the ability to train and supervise quality qualitative data collection. S/he must have the following skills and qualifications:
Ø University Degree in Public Health, Nutrition, Gender, or other related field
Ø Expertise in qualitative data collection and analysis
Ø Excellent writing and speaking abilities in English and local language(s)
Ø Prior experience with Focus Group Discussion facilitation and facilitating in-depth interviews
Ø Prior experience with data transcription
Ø Personable and a good listener
Ø Works well with others, open-minded, non-judgmental
Ø Willingness to travel in-country
Ø Experience and comfort talking about gender issues
Ø Experience using Microsoft Word
Ø Strong typing skills