Terms of Reference Development of Behavior Change Intervention Strategy

for an Improved IFA Supplementation Program for School Going Adolescent Girls in Selected Districts of West Java province in Indonesia

1. Background The prevalence of anemia among adolescent girls and women of reproductive age (15-24 years) at national level is 18.4% (RISKESDAS, Basic Health Research, 2014). However, the data from screening of junior-high school children in Cimahi and Bandung districts in 2013 revealed the prevalence of anemia among adolescents in the range of 40-50% (DHO, Cimahi, 2013). Based on national guidelines (MoH, 1998), it was recommended to give one IFA tablet weekly for 16 weeks consecutively, plus one IFA tablet daily during menstruation for 10 days to adolescent girls. However, the the government’s IFA supplementation program among school-going adolescent girls (including MI’s demonstration districts Cimahi and Purwakarta) was not implemented as envisaged. Some of the reasons for this are:

• Limited availability of IFA tablets, • Limited promotion of the intervention • No clear channel for distribution

Therefore, MI Indonesia proposes a trial on Weekly Iron and Folic Acid (WIFA) supplementation for school-going adolescent girls to reduce the prevalence of anemia among them and reinstate the focus of district and national government on the IFA supplementation program for adolescent girls for improved health outcomes. In this regard, MI seeks local consultant to develop Behavior Change Intervention Strategy and materials on IFA Supplementation among school-going adolescent girls. 2. Objectives The specific objectives of the activity are:

1. Identify the BCI strategy 2. Identify the key messages and tools for the school-going adolescent girls, secondary

school teachers, religion officers, health workers (midwives, cadres, nutrition officers), parents of unmarried adolescents and husbands, in-law of married adolescents, availability and effectiveness of existing materials (if any) on the existing BCI Strategy on IFA Supplementation among school-going adolescent girls.

3. Propose the effective BCI strategy to increase the coverage and compliance of IFA Supplementation among school-going adolescent girls.

4. Propose the effective IEC materials as well as the key messages to increase the coverage and compliance of IFA Supplementation among school-going adolescent girls.

3. Expected Outputs

1. Inputs and recommendations for the effective BCI strategy based on the gaps identification during the discussion with MoH, PHO and DHO to strengthen the IFA Supplementation among school adolescent girls.

2. Input and recomendation for the modification of IEC materials as well as the key messages to be delivered, particularly on the utilization of IFA tablets as well as its

compliance. These will be based on results from the formative (qualitative) research supported by MI which will be conducted prior to the beginning of the consultancy.

3. Plan of action from MoH to improve the strategy and quality of IEC materials based on the inputs and recommendations given by experts during the discussion.

4. Deliverables: 1. Activity reports detail with the executive summary, process of dicussion, results of the

discussion, conclusions and recommendations 2. BCI strategy based on the inputs and recommendations of consultation with key

stakeholders and field visit results. 3. Develop IEC materials based on review results, inputs and recommendations of

consultation with key stakeholders and field visit results.

5. Scope of work

The Consultant will undertake the following tasks: • Review findings of the formative qualitative research for an improved IFA

supplementation program for school going adolescent girls in selected districts (Cimahi and Purwakarta) of West Java province in Indonesia

• Conduct consultation meetings with the Directorate of Nutrition, Directorate of Maternal Health and Directorate of Child Health, Health Promotion Division-Ministry of Health, Ministry of Education and other key stakeholders who are engaged in IFA supplementation program for school-going adolescent girls.

• Identify and review the existing BCI strategy (if any) as well as IEC materials (if any) of IFA supplementation program for school-going adolescent girls.

• Undertake field visits to the selected districts (Cimahi and Purwakarta) in West Java province. Consult with the nutrition and education officers of Provincial Health Office, Provincial Education Office, District Health Office, and District Education Office.

• Documenting all of the discussion process and results (i.e. inputs, recommendation) during meetings and field visits.

• Develop a BCI strategy for the IFA supplementation program for school going adolescent girls program through consultations/workshops.

• Develop appropriate BCC messages. • Review existing IEC materials on the IFA supplementation program for school going

adolescent girls program to reduce iron deficiency anemia Develop and adapt materials for the IFA supplementation program for school going adolescent girls program.

• Pre-testing the IEC materials among secondary school teachers, religion officers, health workers (midwives, cadres, nutrition officers), parents of unmarried adolescents and husbands, in-law of married adolescents as well as adolescent girls themselves

• Refining/ revision of the IEC materials • Discuss/ share with Government and relevant partners. • Incorporate feedback from the stakeholders. • Prepare the final version of IEC materials. • Develop user’s guide for using the IEC materials in English and Indonesia. • Reproduction of the IEC materials will be done by MI.

6. Period of the assignment

The period of consultancy will be for 40 working days.

The consultant will be responsible for developing an expanded timeline of activities for the assessment implementation and managing the scope of work so the timeline is adhered to and the work completed in a timely manner. The first draft of BCI strategy and materials should be completed no later than five weeks after the contract signed. Final deliverables will be due by eight weeks after the contract signed.

Below is detail timeline that expected need to be fulfilled:

No. Activity Number of working days

1. Develop the tools and methods in consultation with MI 2 days 2. Consultations with stakeholders and field travel 12 days 3. Draft BCI strategy, materials and share findings internally

(Country office and Regional Office) 10 days

4. Conduct field test of IEC materials 6 days 5. Presentation and discussion with the MoH and MI on key

findings, specific recommendations as well as the draft of IEC materials proposed.

5 days

6. Finalize report after feedback from dissemination 5 days Total working days 40 days

7. Consultant requirements • Post graduate degree in public health, nutrition, communication or related fields. • At least 5-10 years of experience in the field of public health, communication and

preferable on behavior change intervention program. • Experience with IFA among school-going adolescent girls is prefered. • Competent in written and spoken English. • Previous experience working with MI is an asset