Technical support to ST-SAM project team on Stimulation Therapy for Malnourished Children (ST-SAM) and outreach rehabilitation activities.

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TERMS OF REFERENCE

Stimulation Therapy for Severe Acute Malnourished Children (ST-SAM) – “An Integrated emergency Nutrition, IYCF, and FSL support through adaptive to COVID-19 prevention to South Sudanese refugees in Gambella Region, Ethiopia.” Project component.**

Direction of Operations and Technical Resources- CESAN division

Mission: Providing technical support to ST-SAM project team on Stimulation Therapy for Malnourished Children (ST-SAM) and outreach rehabilitation activities.

1. CONTEXT

Humanity & Inclusion is an independent and impartial aid organization working in situations of poverty and exclusion, conflict, and disaster. The organization works alongside people with disabilities and vulnerable populations, taking action and bearing witness to respond to their essential needs, improve their living conditions and promote respect for their dignity and fundamental rights. Founded in 1982, the organization has been working alongside vulnerable populations, in particular people with disabilities. Currently, HI works in over sixty countries of the world in emergency, reconstruction, chronic crisis, and development contexts. HI started intervention in Ethiopia in 1986 and opened its base in Gambella in 2015.

AS one of its speciality interventions, since 2017, HI has been implementing, in partnership with a nutrition partner, Stimulation Therapy for Severe Malnourished Children (ST-SAM) as an integral part of a project titled “An Integrated emergency Nutrition, IYCF, and FSL support through adaptive to COVID-19 prevention to South Sudanese refugees in Gambella Region, Ethiopia.” The rationale for the ST-SAM intervention is that malnutrition directly or indirectly affect variety of organ systems including central nervous system, which could be aggravated overtime and lead to irreversible disability if not addressed. Thus, Humanity and Inclusion introduced ST-SAM project with the overall objective of preventing developmental delays, cognitive defects and eventual impairments among SAM/MAM children under the age of 5 years. The methodology aims at reinforcing nutritional recovery of SAM&MAM children. The techniques used include adapted individual activities for cognitive and language development as well as physical activities for promoting development of essential fine and gross motor skills and accelerating growth during recovery phase.

Stimulation Therapy for Severe Malnourished Children (ST-SAM) is implemented following emergency nutrition and essential medical care to children suffering from severe acute malnutrition (SAM) to increase chances of survival, for better resilience and improve their future quality of life. The Stimulation Therapy is a direct and effective response to prevent developmental delays and impairments in low- and middle-income countries, even for displaced persons and families living in complex situation like refugee camps.

Since Stimulation Physical Therapy is a new approach, a technical expert has been visiting the project at different times to provide on-the-job training and facilitate quick start and proper set-up of the project implementation. The mission of the technical expert was highly instrumental in introducing the approach/methodology to the project team, partner’s staff (AAH) and community outreach workers.

Currently HI is also providing physical and functional rehabilitation interventions in both refugee camp and Gambella public hospital through both centre based and outreach approaches. The rehab component includes provision of physiotherapy, provision of assistive/mobility devices, usage/maintenance training, caregivers training and awareness raising through various IEC materials developed over the past three years.

The proposed mission aim is to assess current approaches, skills and practices of all ST-SAM project team (physios) on their routine tasks (providing physical/functional rehabilitation as well as early stimulation therapy sessions) and planning to provide support through capacity building trainings and transferring best effective experiences according to the gaps observed.

2. DESCRIPTION OF THE EXPECTED SERVICE

Targeted beneficiaries are all ST-SAM project team (physiotherapists), incentive community outreach workers (recruited from refugee communities), partner staff from Action against Hunger and other physios working within other HI projects in Gambella base.

Global objective of the rehabilitation and stimulation therapy technical expert mission is to provide technical support to the project team on skill and experience gaps for better outcome of overall services delivered by the project. In addition, the technical expert will work on how to demonstrate the impact of ST-SAM project by analysing available beneficiary data. Based on this general purpose of the mission, the following specific objectives are expected during the mission period.

  1. Assess the overall ST-SAM and rehabilitation intervention quality and providing trainings (theoretical/practical) to the physios based on identified gaps to strengthen their capacity and hence, improving quality of the service.
  2. Developing a mechanism of objectively measuring and demonstrating the impact of Stimulation Therapy intervention for SAM children by analysing available beneficiary data (development progress results) before and after ST-SAM intervention.
  3. Reviewing the content of current early children development assessment tool and physiotherapist’s practices in conducting an assessment for any adjustment and modification by incorporating missing elements or new approaches.
  4. Collect and advise all documents and materials developed by the HI Ethiopian team over the past three years in order to share the most relevant documents to the HI Rehabilitation Community of Practice through the intranet: IEC materials, functional rehabilitation documents and assessment, organisation’s tools…

Based on the gaps with regard to tools utilized, essential skills and approaches from the physios and any other factors affecting the overall quality of project interventions, the consultant is expected to provide a support accordingly. These includes, providing technical capacity building trainings to the physios, adapting effective and recognized approaches for rehab & stimulation therapy interventions and developing quantitative ST-SAM intervention impact demonstrating methodologies.

Sources /tools that can be considered:

  • MDAT (Malawi development assessment tool) which is used to assess early children development status for U5 malnourished children

  • Physical/functional rehabilitation assessment tool utilized to assess PWDs to set treatment goals.

  • U5 children development progress data (assessed with MDAT tool) for most of the children admitted into ST-SAM program.

  • ST-SAM manual and guideline.

  • Others proposed by the consultant

HI will share these documents and other related information with the consultant.

It would be important that the proposed modified tool and recommended working approaches by the consultant will be tested in practical by all project team to ensure its adoption for the future.

The developed method used to demonstrate ST-SAM intervention impact is expected to be explained to our consortium partner staff (AAH) by organizing an event.

3. CONSULTANT’S PROFILE **

  • Bachelors or Master’s degree in physiotherapy or occupational therapy.

  • More than 5 years of work experience in early child development and physical/functional rehabilitation.

  • Proven experience in tool development and data analysis to show the impact of the project in measureable manner. Knowledge about the MDAT is highly recommended.

  • Experience in providing trainings and preparing different training materials to be used as a guide by new physios joining in the future.

  • English as a Working language.

4. DURATION AND PLACE OF PERFORMANCE OF THE SERVICE

Ø Start date : 1st June 2021

Ø End date: 31st July 2021 (2 months)

Ø Schedule and number of mission days to be worked by the consultant (specify whether a briefing or debriefing is planned at HQ or elsewhere): The number of mission days is the number of days spent in the place of performance of the mission, including weekends and public holidays, + the days needed for briefings, debriefings and reports.

01-02/06/2021

Location Arrival Addis

Content Briefing with Country Director + review of Agenda + security briefing.

03/06/2021

Flight to Gambella

Meeting with operational manager and Project Manager for briefing on general situations in Gambella.

04-30/06/2021

Gambella

· Having discussion with all project team and Rehabilitation Specialist from Headquarters on training needs, areas where support is needed, general project intervention information, and context understanding.

· Preparing work plan according to the schedule stated in the ToR.

· Visit to the refugee camp and host community institutions to understand the whole contexts and to figure out on steps to follow to identify the specific support needed.

· Identifying gaps with regard to knowledge, skills, experiences and tools used by the physios to figure out on how to prepare to solve those gaps.

· Collecting documents, materials and tools used by the team.

· Preparing training materials on the identified areas regarding skills, procedures and technical knowledge.

· Organizing the training for the project team according to the identified gaps.

· Providing practical supportive supervision to the physios to ensure the adoption of new experiences, skills and knowledge given by the consultant on the training.

01-31/07/2021

Gambella

· Assessing overall contents of assessment tools and practices of using the assessment tools to work for potential modification and adopting best practices.

· Modifying the current approaches of recording beneficiary assessment results/data in such a way that it would be easier to show the impact of ST-SAM project intervention.

· Working on how to demonstrate ST-SAM impacts by analysing available beneficiary data using easy to understand method of explaining the results.

· Finalizing ST-SAM project impact analysis and organizing a workshop to explain the findings to the consortium partners (AAH).

*Regular skype meeting will be organized with project’s Rehabilitation Specialist in between and at the end of the mission

*Technical expert will travel to one of Ethiopian neighbouring countries (Kenya) at the end of every month for visa renewal processes.

Briefings and debriefings will take place at both Addis and Gambella.

Service location is mostly in Gambella base with frequent field visit and working at HI Gambella office.

As already indicated above, the tools modified (in either content or procedures of using) will have to be tested in practical application by the physios.

During the performance of the service, the consultant will be required to work in liaison with Handicap International’s teams, and notably with Mr Rozenn Beguin (rehabilitation technical reference at HQ).

5. WORK PLAN

HI expects to receive:

  • A Technical note explaining the methodology the consultant intends to use and the scope of work (s)he intends to apply. Further, the technical note should also highlight the understanding of the consultant of the proposed assignment and clearly state the deliverables the consultant will provide at the end of the assignment.

  • An operational note stating the precise planning and work schedule with applicable fees, overall budget, activity planning.

  • Consultant’s CV and illustration of experience.

6. REPORT

Working language is English:

  • Identified training needs on skill, experiences and knowledge by the physio particularly newly recruited physios should be described.

  • Any modification to the assessment tool, method of explaining ST-SAM project impact, details of technical training provided by the consultant need to be included in the report.

  • Collection of reviewed documents, tools and material already used by the team and the new ones created during the assignment.

  • Submission date: 31st July 2021

7. CONTACT PERSON

  • During the mission, the consultant will be required to work in liaison with Handicap International’s team in Ethiopia; notably with Nebiyu Embibel (Operational Manager, HI Gambella & Benishangul areas), Gadisa Obsi (PT, ST-SAM PM) who will be his/her contact person.

8. VALIDATION

Contractor (Last name Forename Position Date and Signature)

Consultant (Last name Forename Date and Signature) **

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