Position Title: Nutrition Information Systems Specialist
Receiving Agency: UNICEF
P Level: P3
Location: Kabul, Afghanistan
Duration: 10 weeks 
Language: English

Introduction

In the 2024, concerns were raised about the consistency of critical nutrition data from various sources analyzing vulnerable populations in Afghanistan. There was a recognized need to review and harmonize the nutrition need analysis approach to ensure reliable and timely decision-making for key donors, particularly regarding targeting and resource allocation. Responding to these concerns, FCDO supported a review of nutrition information availability, access, analytical methods, and overall usefulness in decision-making and communications.

Following a review of the current nutrition-relevant information system in Afghanistan, a number of challenges were identified, and recommendations were proposed as follows:
 

1. Strengthen the functionality of the existing nutrition-relevant information system within the health system to cover both long and short-term information requirements.
2. Address deficits in data quality and reliability.
3. Increase relevance of data to strengthen evidence-base for interventions and address data deficits.
4. Institutionalise multi-sectoral analysis of nutrition information to strengthen the evidence base of recommendations.
5. Ensure coherence and credibility of analysis and recommendations by facilitating a process of consensus building on key messages.
6. Leadership to guide, advocate for support and ensure intersectoral collaboration for implementation of recommendations.

This Terms of Reference focuses primarily on implementation of Recommendations 4 and 5, while also expecting to interact closely with and influence Recommendations 1, 2 and 3.

Background

Afghanistan continues to grapple with a humanitarian crisis with most of its population living in chronic poverty and deprivation, worsened by a complexity of climate-related and natural disasters, as well as social and economic challenges. The current humanitarian crisis in Afghanistan is widespread and severe, with a projected 23.7 million people- more than half of Afghanistan’s population expected to require humanitarian assistance in 2024 (HNRP 2024).

Malnutrition remains a major challenge impacting the lives of millions of people in Afghanistan, especially young children and women. The drivers of malnutrition can be identified across a number of sectors, most significantly health, food, water and sanitation, gender and social protection. High levels of food insecurity and disease burden and poor maternal and infant and young children feeding practices, compounded by economic instability, inadequate health infrastructure and low access to health and WASH services, frequently occurring disasters and a deteriorating situation for women are major contributors to malnutrition. Poor feeding practices for infants and young children are major factors strongly linked with undernutrition, with only 58% of children under six months being exclusively breastfed. The national average for achieving Minimum Dietary Diversity is 14.8%, although some provinces score as low as 2.8%. Food insecurity, a key driver of malnutrition, affects a large proportion of the population, especially in rural areas. Recent IPC analysis in 2024 shows that approximately 2.9 million people residing in rural areas face emergency levels (IPC Phase 4) of food insecurity. A high influx of returnees from neighbouring countries especially Pakistan and an increasing number of internally displace persons due to frequently occurring natural disasters such as flash floods and earthquakes have put additional constraints to meeting the essential needs of these populations.

Current estimates show that 3.2 million children under five and 0.8 million pregnant and lactating women require sustained life-saving treatment services in 2024, this includes approximately 0.9 million children under five with severe acute malnutrition (HNRP, 2024). Young children under the age of 2 years face the highest burden of malnutrition with over 90% of all inpatient admissions for treatment of severe acute malnutrition (SAM) in this age group (Nutrition Cluster). High levels of micronutrient deficiencies persist, including iron, iodine, zinc, and vitamin A, which affect the health and development of children and women.

Within this context, collection of ‘gold standard’ representative data on the nutritional status of highly vulnerable populations has not been possible in recent years and although estimates of malnutrition have been derived, significant gaps remain and the absence of a recent multi-sectoral analysis of nutrition has also presented significant constraints to evidence-based decision-making in relation to addressing malnutrition and identifying its drivers across multiple sectors.

In recent years, it has been challenging to gather 'gold standard' representative data on the nutritional status of highly vulnerable populations, due to lack of SMART surveys. While estimates of malnutrition have been made, there are significant gaps in the data. Additionally, the lack of a recent multi-sectoral analysis of nutrition has constrained evidence-based decision-making, making it difficult to address malnutrition effectively and identifying its drivers across multiple sectors.

Purpose

The overall objective of this technical support is to enable a stronger evidence base for decision-making related to targeting, context-specific programme design and resource allocation related to nutrition in the most vulnerable populations in Afghanistan.

Within the unique reality of Afghanistan, with continued constraints in access to population, restrictions on the nature and frequency of data collection and yet a continued demand and need for evidence-based decision-making, the Nutrition Cluster aims (i) to develop innovative and viable processes and methods to strengthen multisectoral nutrition need analysis and (ii) to communicate evidence-based messages to inform decision-making.

Scope of work

Despite the challenges described, Afghanistan has multiple sources of nutrition-outcome information collected through routine, sentinel site and programme monitoring sources. Nutrition-relevant information on key drivers of malnutrition from health, food, WASH and other social sectors is also available. Existing ‘gold standard’ data collection and analytical approaches are not currently possible, but significant opportunities exist to optimize all available data to produce the kind of robust evidence required to inform decision-making. The technical support will focus on supporting the Nutrition Cluster to optimize available resources including data, systems, structures, analytical process and technical expertise to achieve this objective. The emphasis of this assignment is on developing approaches which can be institutionalised in existing systems and structures and will be repeated twice yearly, or as required.

Key tasks and deliverables

1            Routine Nutrition Programme data analysis
 

• In collaboration with UNICEF, PND and implementing partners, establish a framework for Routine Nutrition Programme data analysis from multiple data sources, with a focus on (i) detecting fluctuations in wasting and (ii) to inform response.
• Outline structure, process and guidance for data analysis, presentation and interpretation at regional and national levels.
• Identify specific deficits and data quality issues that need to be addressed.

2            Nutrition outcome data analysis
 

• Outline and describe a credible approach for triangulating and extrapolating nutrition outcome data in the absence of SMART Surveys. (Process is in progress but method not documented)

3            Periodic Nutrition Multisectoral analysis
 

• Define strategy for undertaking multisectoral need analysis of nutrition, to better inform situation and drivers.
• Establish framework outlining data types, processes, and communication products for nutrition multisectoral analysis.
• Establish Analytical framework – considering existing processes - IPC AMN, hotspot analysis, NAWG (Needs Monitoring Framework), ICCT (OCHA, REACH and IOM)
• Develop Risk Monitoring Framework to complement the periodic Nutrition Multisectoral analysis.
• Strengthen analytical structures and processes at national and regional levels, including standard protocols for analysis, discussion structure, interpretation of findings, and formulation of conclusions and recommendations.
• Define consensus building approach and process to reach joint agreement on interpretation and recommendations related to nutrition.
• Outline an accountability framework.

4            Communication strategy
 

• Define overall communication strategy to ensure consistency and clarity of messaging on nutrition situation and recommended actions, targeting specific information users and decision-makers.
• Propose format for briefs and statements that complement existing standard products (maps, dashboards etc.) with consensus-based analytical statements, aiming to build credibility and inform timely decision-making in relation to programme adjustments, context-specific programme design and resource allocation.

 
Collaboration

The primary beneficiary of this support is the Nutrition Cluster and all aspects of the work will be undertaken in a manner that ensures sustainable capacity is developed, within the existing structures and systems. Key collaborating partners will include UNICEF, WFP, WHO Public Nutrition Directorate (for routine data), OCHA and the Assessment and Analysis Working Group.

Close interaction with IPC (in-country and global) and Global Nutrition Cluster is expected, to ensure broader input into and buy-in to the proposed analytical approaches.

Timeline

The total number of days support required for this assignment is 60 days, over a four-month period, commencing in September 2024.

It is expected that approximately 60% of the support will be provided in-country.

Experience and qualifications

The technical assistance is expected to have specific expertise and experience in using a range of data to undertake both nutrition-specific and multi-sectoral analysis of nutrition in complex environments. A strong familiarity with IPC and Global Nutrition Cluster is essential. Knowledge of the Afghanistan context and previous experience working in similar settings will be considered an added advantage.
Annex 1
Recommendations on strengthening nutrition-relevant information system to strengthen evidence-based decision-making

1. Strengthen the functionality of the existing nutrition-relevant information system within the health system to cover both long and short-term information requirements.

Develop graphic and descriptive illustration of nutrition information within existing health systems. Reach agreement on data standards, purpose, flow, access, use etc. Define roles, responsibilities and accountabilities at national and subnational levels. Review and revise the existing data systems (HMIS, NIS, Surveillance) to ensure tools are fit-for-purpose and reduce data-related workload on health facility staff and community health workers.

2. Address deficits in data quality and reliability.

Build confidence in available data through fully functioning data quality mechanisms and checks. Identify capacity gaps and design tailored support. Explore opportunities to utilise technology for data entry and transmission. Optimise integrity and use of all data to inform decision-making.

3. Increase relevance of data to strengthen evidence-base for interventions and address data deficits.

Address coverage gaps and representation deficits for groups with higher vulnerabilities. Ensure availability of timely and disaggregated data on most vulnerable population groups to inform more efficient targeting of appropriate interventions and to monitor impact. Support national and critical small-area SMART surveys (which will require close engagement with the DfAs).

4. Institutionalise multi-sectoral analysis of nutrition information to strengthen the evidence base of recommendations.

Support and facilitate periodic multi-sectoral analysis of nutrition. Formalise and document approaches used for extrapolation and triangulation of nutrition data in the absence of SMART surveys. Intensify existing engagement with initiatives such as IPC and REACH to identify pathways towards inclusion of nutrition data in existing multisectoral analysis and monitoring. Identify and include populations who are under-represented or excluded from data to add to the credibility of the analysis.

5. Ensure coherence and credibility of analysis and recommendations by facilitating a process of consensus building on key messages.

Institute systems and mechanisms for reaching agreement or consensus on interpretation of information and communication of consistent evidence-based messages to inform decision-making.

6. Leadership to guide, advocate for support and ensure intersectoral collaboration for implementation of recommendations.

Identify and support leadership to advocate for collaboration and promote access to adequate technical and financial support. Ensure all recommended focus areas are addressed, to strengthen evidence-based programming.

CANADEM and its partners have a no-tolerance policy for inaction to prevent, respond to and follow up on alleged cases of Sexual Exploitation, Abuse, and Harassment (SEAH). For this reason, we adhere to all policies, procedures and training of the United Nations on The Prevention of Sexual Exploitation, Abuse, and Harassment (PSEAH). CANADEM mandates all deployees successfully complete the PSEA online course. This e-learning course is composed of a set of lessons designed to raise awareness about SEAH, become familiar with a range of measures to combat SEAH, understand the impact on victims and the consequences for UN Personnel who commit Sexual Exploitation, Abuse, and Harassment.