NATIONAL GUIDELINES ON MATERNAL NUTRITION FOR HEALTHCARE PROVIDERS Closing date (05-Aug-2024) NOTE: PLEASE SUBMIT TECHNICAL & FINANCIAL PROPOSALS

Note: we only need proposals not only resumes. 

Please email your Technical & Financial Proposals at tasawar.khalique@peopleperfectae.com maximum by 5th Aug 2024.

National Guidelines on Maternal Nutrition for Healthcare Providers

TOR

1. Background

Nutrition International is a global nutrition organization headquartered in Ottawa, Canada. For more than 30 years, we have focused on delivering low-cost, high-impact nutrition interventions to people in need. Working alongside governments as an expert ally, we combine deep technical expertise with a flexible approach, increasing impact without increasing complexity or cost. In more than 60 countries, primarily in Asia and Africa, Nutrition International nourishes people to nourish life.

In Pakistan, Nutrition International has been working since 2001 in partnership with national and provincial governments to improve the nutrition of children under 5, pregnant women, adolescent girls, women of reproductive age and the general population through nutrition-specific interventions on micronutrient supplementation, food fortification and birth package. Nutrition International also works on nutrition governance to build an enabling ecosystem of health and nutrition policies in the country.

1. Rationale

Maternal Nutrition is the cornerstone for maternal and child health, requiring focused attention to prevent stunting and wasting among children. However, maternal nutrition indicators for women of reproductive age (WRA) in the Pakistan are alarming, with 14.4% underweight, 24% overweight, 13.8% obese, 41.7% anaemic, and 22.4% experiencing Vitamin A deficiency.

Adequate nutrition during pregnancy can prevent maternal complications, reduce the risk of low birth weight, and promote optimal fetal growth and development. The Pakistan Maternal Nutrition Strategy (PMNS) 2022 highlights the critical role of Health Care Providers (HCPs) both in the public and private health sectors, necessitating comprehensive and evidence-based national guidelines on maternal nutrition tailored for HCPs to ensure consistent and effective care across healthcare facilities in Pakistan.

The Maternal Nutrition Campaign NourishMaa aligned with the PMNS 2022, is a collaborative effort between Nutrition International (NI), the Ministry of National Health Services, Regulation and Coordination (MoNHSR&C), Provincial Departments of Health (DoH), and key stakeholders such as the Pakistan Medical Association (PMA) and the Society of Obstetrics and Gynecologists Pakistan (SOGP). SOGP indicated the knowledge gaps of Health Care Providers (HCP) providing maternal and child health (MNCH) services in the country related to specifics of Maternal nutrition standards, guidance for counselling, weight monitoring, updated supplementation standards etc. With this gap identified SOGP has requested the NoursihMaa campaign to develop National standards for Maternal nutrition to be used by HCPs working in the MNCH disciplines. This maternal nutrition guideline will serve as a national guidelines endorsed and released by the SOGP for the MNCH cadres across the country. This consultancy aims to provide HCPs with a comprehensive tool to enhance maternal nutrition outcomes in Pakistan.

1. Objective

The objective of this consultancy is to develop national guidelines on maternal nutrition through the lifecycle approach including nutrition guidance for Adolescent girls, Women during pre-pregnancy period, pregnant women during ANC period and postpartum women. The guideline will encompass evidence-based recommendations and best practices to optimize maternal health outcomes.

Target group for these guidelines are

1. SOGP members.
2. Doctors providing services to women in reproductive age group - pregnant and non pregnant
3. Community Midwives, Lady Health visitors etc.

1. Scope

The guideline would capture recommendation on providing following clinical services

1, Assessment of nutritional status

2. Provision of the micronutrient supplementations as preventive approach

3. Provision of counselling on adequate/balanced diet and diet diversity for adequate healthy weight gain

4. Management of special conditions like, Anaemia, underweight, obesity and or gestational diabetes etc.

5. Etc. not limited to above

For women across different life cycle i.e.

• Adolescent pre-pregnant girls,
• Pre-pregnant young women
• Pregnant women adolescent and adult
• Post partum women

This information would provide the agency a direction for their desk review and evidence generation process for drafting of the guidelines

1. Desk review:

The consultant(s) will describe the methodology for the desk review in the technical proposal report and enlisting the type of documents to be reviewed. The desk review will include (but not limited to) an in-depth review of existing global and national guidelines, scientific literature, evidence-based practices related to maternal nutrition, and identify key areas of focus and priority topics for the national guidelines based on gaps and needs analysis.

1. II. Stakeholder consultation:

The consultant(s) will facilitate consultations with relevant stakeholders through Key informant interviews, including Society of Obstetrics & Gynaecologists Pakistan (SOGP), Pakistan Medical Association (PMA), Ministry of National Health Services Regulations & Coordination, Provincial Departments of Health, nutritionists, public health experts, development partners etc. to gather feedback and ensure buy-in for the guidelines. The consultant is expected to outline the methodology, list of stakeholders, tools etc in the technical proposal.

1. III. Formation of a technical working group

The technical proposal shall outline approach for the formation of a TWG with key relevant experts from SOGP, PMA of Nutrition Wing etc. Please outline how you would facilitate this TWG and get final inputs and buy-in for the development of final draft of the guideline. What will be the expected role of the TWG in consultations, reviews and vetting.

1. IV. Drafting of the Guidelines:

Furthermore, the consultant(s) will draft evidence-based recommendations and guidelines on maternal nutrition, including dietary requirements, supplementation, nutrition assessment, weight management, and management of common maternal nutrition-related conditions and complications. The consultant is expected to describe the process they will adopt while developing the guideline including a draft guideline template outline in the technical proposal. The consultant(s) will develop clear guidelines and support tools to aid doctors in implementing the recommendations in clinical practice. The consultant(s) will incorporate stakeholder feedback, finalize the guidelines accordingly to ensure accuracy, relevance, and practicality, and develop accompanying training materials and dissemination strategies.

1. Deliverables:

The consultant(s) shall deliver the following:

Deliverable 1: Inception report covering the proposed methodology, work plan, and timeline for the consultancy.

Deliverable 2: Draft national guidelines on maternal nutrition, accompanied by supporting materials and tools.

Deliverable 3: Summary report documenting stakeholder consultations, including feedback received and revisions made to the draft guidelines.

Deliverable 4: Develop a national technical working group with representation from SOGP, PMA, MoNHSR&C for consultation, coordination and vetting.

Deliverable 5: Final version of the national guidelines on maternal nutrition, incorporating all revisions and feedback received.

Deliverable 6: Training materials and resources designed to enhance capacity building for the implementation of the guidelines.

1. Timeline:

The consultancy is expected to be completed within 45 days from the date of commencement, with specific milestones and deliverables outlined in the work plan.

1. Qualifications:

Nutrition International seeks knowledgeable and experienced consultant(s) to develop national guidelines on maternal nutrition. The consultant(s) should possess a proven experience of working on policy levels and drafting national/regional and provincial strategies/guidelines. The following qualifications and experience is required:

1. Advanced degree in medicine, nutrition, public health, or related field.
2. Demonstrated expertise and experience in maternal newborn and child health, particularly in the area of maternal nutrition.
3. Experience in developing evidence-based clinical guidelines and protocols.
4. Strong research and analytical skills, with the ability to critically appraise scientific literature.
5. Excellent communication and stakeholder engagement skills.

Familiarity with the healthcare system and policy landscape of Pakistan