ToR- For Conducting an Endline Study: Comprehensive Management of Severe and Moderate Acute Malnutrition (SAM and MAM)...

TERMS OF REFERENCE (ToR)

For Conducting an Endline Study/Impact assessment Under the Project Titled

Comprehensive Management of Severe and Moderate Acute Malnutrition (SAM and MAM) / The Acute Malnutrition Management Action (AMMA) in Andhra Pradesh and Rajasthan

1. Brief about the Organizations

Vijayavahini Charitable Foundation(VCF):

Vijayavahini Charitable Foundation(VCF) is a not for profit organization which focuses on a wide range of themes, including livelihood promotion, agriculture, sanitation, nutrition, education, skill development and conservation, among others. VCF has anchored multiple nutrition projects, including Strengthening ICDS system and promoting rice fortification. VCF is implementing and managing the project across 3 districts in Andhra Pradesh, with support from Tata Trusts and TINI. VCF proposes to intervene in Parvatipuram Manyam, NTR, and Tirupati districts, given the burden of SAM and MAM children as well as to build synergies with existing initiatives.

Since 2018, VCF has been actively engaged in various programs aimed at improving nutrition standards in rural communities across Andhra Pradesh. As part of this integrated project, VCF successfully transformed over 280 Anganwadi Centers (AWCs) and provided training to 12,000 Anganwadi workers. Additionally, VCF intervened to address Micro nutrient deficiency and collaborated with the AP government to supply nutrient-rich fortified rice to children and mothers through the Mid-Day Meal (MDM) and ICDS schemes.

Centre for microFinance:

Centre for microFinance (CmF), Jaipur (www.cmfraj.org) is a Rajasthan-based non-profit organization set-up in 2007 to catalyze the growth of community based microfinance and agriculture-based livelihoods. Since 2015, CmF has expanded its functional domain to include education, skilling, nutrition, water, and sanitation. It works with multiple stakeholders such as government programs and departments, non-government organizations (NGOs), banks, community organizations (especially Self-Help Groups and SHG Federations) and donors. CmF currently serves as a technical partner to the state government’s rural livelihoods and education programs, and Rajasthan Grameen Aajeevika Vikas Parishad (RGAVP)’s FNHW (Food Nutrition Health and Wash) interventions. CmF is also the implementing agency of Tata Trusts (www.tatatrusts.org) in Rajasthan. CmF has been implementing field-level interventions in Sirohi district since 2016. CmF has district-level MoU with the Sirohi district administration.

To address the challenge of Malnutrition, Centre for microFinance (CmF) an associate organisation of Tata Trusts has been implementing the project “Comprehensive Management of Severe and Moderate Acute Malnutrition (SAM and MAM)” in four districts of Rajasthan. In Rajasthan, the intervention is being implemented under the Acute Malnutrition Management Action (AMMA) approach, which focuses on strengthening the identification, referral, management and follow-up of children affected by acute malnutrition through community-based interventions and strengthened government systems.

2. Background of the project

The science of human nutrition deals with all the effects on people of any component found in food1. This starts with the physiological and biochemical processes involved in nourishment – typically encompasses two major areas;

How substances in food provide energy or are converted into body tissues, and

The diseases that result from insufficiency and excess of essential nutrients (malnutrition).

The scope of nutrition extends to any effect of food on human function. The study of nutrition overlaps with the social sciences of psychology, anthropology, sociology and economics. A healthy diet means different things to different people. Those concerned with children’s nutrition—parents, teachers and paediatricians aim to promote healthy growth and development.

Growth is a fundamental physiologic process that characterizes nutrition. Good nutrition is essential for survival, physical growth, mental development, performance, productivity, health and well-being across the entire life-span: from the earliest stages of foetal development, at birth, and through infancy, childhood, adolescence and on into adulthood2.

1. Scope of Work / Assignment

The overall objective of the Endline Study/Impact assessment is to assess changes achieved during the project implementation period and compare them against the baseline assessment.

Conduct Impact assessment of the project intervention and control districts, with comparison to baseline findings to assess contextual changes.

Measure current nutritional status of children aged 0–5 years, including stunting, underweight, wasting (SAM, and MAM) and compare with baseline datasets.

Assess changes in infant and young child feeding practices, maternal nutrition practices, and health-seeking behaviour in comparison to baseline.

Evaluate community knowledge, awareness, and practices related to nutrition, health, and WASH, with reference to baseline levels.

Assess access, utilization, and quality of ICDS and health services, including THR, growth monitoring, and other key interventions, compared to baseline.

Review functionality of service delivery platforms (AWCs, Sub-Centres, MTCs) along with infrastructure and equipment availability, compared to baseline situation.

Assess effectiveness of SAM/MAM case management, referral systems, and follow-up mechanisms, in comparison with baseline performance.

Examine the role and engagement of stakeholders and community institutions (PRI members, SHGs, Mothers’ Committees, etc.) and changes since baseline.

Assess knowledge and practices of frontline workers (AWWs, ASHAs, ANMs) on key nutrition services and compare improvements from baseline.

Identify key changes, gaps, challenges, and document best practices, innovations, and lessons learned across the project period.

For detailed information, please check the complete version of the RFP attached below.