Consultancy for Combined Knowledge Attitude and Practice (KAP) and barrier analysis survey

a) Location : Akobo County, Jonglei State, Republic of South Sudan
b)Duration : 40 days during the period August – September 2011
c) Start Date : Upon signing the contract

d) Reports to : Medical Team (Medical Director & Nutrition Technical Teams)
e) Context
International Medical Corps has been present in Central Lou (formerly Bieh State), Jonglei State, since 2005. The largest of the 10 states in South Sudan, Jonglei State, has one of the harshest environments. The terrain and lengthy rainy season make transport and travel difficult-to-impossible during the rainy season, leaving populations to rely entirely on locally available resources. Akobo County is located along the eastern border of Jonglei State, adjacent to Ethiopia. It has a population of 136,210 including 26,534 IDPs. The inhabitants of Akobo County are primarily agro-pastoralists who practice simple subsistence farming. A large part of the population moves to cattle camps during the dry season, returning home to plant in the late spring/early summer.

International Medical Corps has been providing primary health care in Akobo West and secondary health care through Akobo Hospital since 2008. High malnutrition rates in Akobo result from lack of access to and availability of food access. Equally important underlying factors are widespread illness, suboptimal infant and young child feeding (IYCF) and care and virtually non-existent basic services like primary health care and sanitation.

Recent national-level surveys such as the Sudan Household Survey and the Vulnerability Assessment and Mapping have shined light on underlying behavioral causes of malnutrition in Southern Sudan generally. International Medical Corps has received funds to expand its nutrition program in Akobo County in response to the high nutrition rate. The program will incorporate behavior change communication (BCC) activities beyond the OTP, SC and SFP service delivery points to become a larger-scale social and behavior change (SBC) program.

To build upon knowledge from national-level surveys, International Medical Corps will conduct a knowledge, attitudes and practices (KAP) and barrier analysis survey, early in the project to gain a more thorough understanding of specific behavioral factors underlying malnutrition in Akobo County and to gain a better understanding of formal and informal local leadership and the role of traditional healers. Understanding the barriers to optimal feeding practices will enable International Medical Corps to better develop targeted messaging, thus ensuring a more profound uptake of those messages. This will increase the actual impact on the adoption of healthy behaviors and, in the long run, the impact on nutritional status
f) Methodology:
The survey will look at the knowledge, attitude, and practices, as well as barriers to practicing, relating to Infant and young child feeding. The survey will be conducted in a participatory manner that will enable government counterparts from the Ministry of Health (MoH), other partners and beneficiaries to participate. The process will entail discussions on and an orientation to the overall task to agree on the requirements and to refine the scope and added value of the outcome documentation. It will involve a series of consultative meetings and related sessions to finalize planning.

g) Survey scope
• Clear research: a definition of the survey approach and methodology, with a detailed survey population clearly defined. The survey should target representative communities in Akobo County with a focus on pregnant and lactating women and those that are not breastfeeding but in child-bearing age, and key household decision-makers such as men and grandmothers. Other key informants should be identified, including but not limited to MOH personnel, religious leaders, traditional healers, community leaders, etc.
• Sampling and estimating the sample size: Definition of the representative target population. The sample size will be determined by appropriate sampling techniques and the chosen level of precision agreed upon by International Medical Corps and the consultant.
• Methodology: Focus group discussions (FGD) and key informant interviews (KII) following interview guides, and survey of a random sample of residents. Guides and questionnaires should be developed in consultation with International Medical Corps program staff.
• Entering and analyzing data and drafting a report: The report must provide a clear picture of the current knowledge and practices as well as the barriers to optimal IYCF practices and care, and recommendations on the priority behaviors to address and how to address the barriers to those behaviors. Quality Control: A clear descriptive of the quality control mechanism that will ensure a quality survey.
h) Timeframe:
• The duration of the survey will be 40 days (including final report submission). The start date will be the date of contract signature.
g) Expected Deliverables by the end of the consultancy:
Inception plan (within 7 days of commencement): The consultant is expected to submit a detailed plan for how the survey will be carried out. The plan will outline the tools and detailed work plan for the entire exercise.
KII and FGD guides (within 5 days of start)
Questionnaire (within 1 week of start)
Final Report (within 40 days after start):
1. The knowledge, attitudes and practices, and barriers with regard IYCF, including how this links to norms, values and beliefs. The report should clearly identify the positive attitudes and best practices that need to be enhanced and the negative attitudes and poor practices that need to be addressed to improve behaviors in relation to IYCF and the SBC strategy to put in place.
2. This report should incorporate specific realistic and achievable recommendations, including the most appropriate behavior change communication strategies and messages that can be undertaken by the communities to address the issues highlighted.
3. A draft of the report will be shared with key stakeholders for review and before the end of the consultancy to allow time for refinement before the release of the final report. All data must be provided electronically and all filled surveys remain the property of International Medical Corps.
4. Handover notes.
h ) General Conditions of the consultancy :-
• Accommodation will be provided by International Medical Corps in the program sites, which is the usual shared accommodation.
• The consultant will cover fully his/her food and subsistence related cost, so the price component must contain an overall quotation reflecting these costs as well.
• The consultant will conduct his/her work using his/her own computerequipment. Other costs related directly to the task, like photocopying of questionnaires, shall be covered by International Medical Corps.
• The movement of the consultant and team to and from the field will be facilitated by International Medical Corps.
• The cost related to travel to South Sudan and to Akobo, shall be covered by International Medical Corps using the available, convenient, economical transport.
• Final payment to the consultant will be dependent on the completion of all deliverables, as well as hand-over notes.
i) Expected background and Experience of the Consultant:-
• Advanced Degree and experience in surveys and assessments
• A reputable consultant with documented experience in conducting KAP studies relating to IYCF.
• The consultant should preferably be a holder of a post graduate degree in public health, sociology, anthropology or related discipline. S/he must have strong analytical, negotiating, communication and advocacy skills.
• Qualified South Sudanese or International consultant who is fluent in spoken and written English.
• The consultant must have a strong background in statistics and data analysis. Must be familiar with Statistical Package for Social Sciences (SPSS) in particular and all relevant computer applications in general.
• Excellent reporting and presentation skills.
j) Submissions and Deadline:
International Medical Corps is looking forward submission by interested qualified candidates should be received by 10th August 2011

Email CVs and letter of intent to the International Medical Corps South Sudan Program –at the following email address:
hrssudan@internationalmedicalcorps.org