Term of Reference

Improving the coverage and adherence of IFA supplements

Among pregnant mothers for reducing iron deficiency anaemia

in 2 provinces of Indonesia (West Java and Banten)

1. Background

MI has supported the Government of Indonesia to demonstrate a model for increasing coverage and

adherence of Iron Folic Acid supplements among pregnant women to reduce iron deficiency and iron

deficiency anemia among pregnant women between 2011 and 2014 in one district each of Banten

(Lebak) and West Java (Purwakarta) provinces.

Based on the findings of the demonstration project, MI is going to replicate the elements of the

processes which have worked to improve coverage and adherence of the IFA program in 4 provinces

(West Java, Banten, West Nusa Tenggara and Riau). During the first 2 years, MI will scale up the

program in West Java and Banten province followed by West Nusa Tenggara and Riau in years 3 and

4. The proposed project component will focus on:

Strengthening government commitment and integrate with other programs. Tailored capacity building and BCI interventions for health staff, midwives and cadres to

provide effective counseling to ensure high utilization rates. Streamlining the supply chain of IFA program at district, province and national levels. Streamlining program monitoring and supervision from national until district levels. National level technical assistance on improving the IFA supplements re-formulation, HMIS

and revision of national guidelines.

In order implement the project during the first year, MI seeks local agency to facilitate the

implementation of project component activities.

2. Objectives

The objective is to facilitate MI for the implementation of following activities related to IFAs scale up:

1. Advocacy meetings among stakeholders at central, provinces and districts levels

2. Program review and monitoring meetings among DHO (District Health Officers)

and PHO (Province Health Officers)

3. National level Train of the trainers (ToT) by MoH (Ministry of Health)

Central Officers to the Province Health Officers.

4. Training on systems, tools and product specifications for planning, delivery and monitoring of

the program for District Health Officers

5. Training on supply chain management for District Health Officers

3. Methodology

3.1. Advocacy meetings

3.1.1. Advocacy meeting at national level

Advocacy meeting will involve stakeholders of IFA supplementation program at national level.

Participants will be about 60 people which are:

PHO officers from West Java and Banten province

DHO officers from West Java and Banten province

MOH Central officers from Jakarta

UN Agencies (UNICEF, WFP, WHO) and MCA-I (Millenium Challenge Account-

Indonesia)

International NGOs (Hellen Keller Indonesia, GAIN, Plan Indonesia, World Vision,

Save the Children)

Universities and experts

Industries related to IFA supplementation production (Kimia Farma, Indo Farma).

MI extenders

The discussion will be done to advocate and identifying appropriate strategies for improving IFA

utilization rates and integration with other existing maternal health program. The contribution from

other agencies to support IFA program will be also integrated and collaborated with MI program

3.1.2. Advocacy meeting at province level (2 meetings - in Banten and West Java)

Advocacy meeting to the policy makers will be done among stakeholders at province level in

two provinces (Banten and West Java).

Participants in each meeting will be about 40 participants which are:

MoH officers

PHO officers

DHO officers

Province Secretary/Parliament staff

Womens organizations Province Planning Board (Bappeda),

Bureau of Religious Affairs (KUA),

Community Empowerment Office

Community leaders

Nation Wide Community Program (PNPM),

Midwives Association

MI extenders

The meeting is to propose recommendations to improve program monitoring and reporting for

better decision making to province and district level. In addition, the meeting will strengthen

the integrated and inter-sector programs to improve IFA program implementation

3.1.3. Advocacy meeting at district level (in 20 selected districts in 2 provinces- 15 districts in West

Java and 5 districts in Banten)

Advocacy meeting to the policy makers will be done among stakeholders at district level.

Participants in each meeting will be about 20 participants which are:

PHO officers

DHO officers

District Secretary

Womens organizations

District Planning Board (Bappeda)

Bureau of Religious Affairs (KUA) at district level

Community Empowerment Office at district level

Community leaders,

Nation Wide Community Program (PNPM) at district level

Midwives Association at district level

MI extenders

The discussion will be done to advocate adequate allocation of budget for procurement of

adequate IFA supplements and operational costs for program implementation and monitoring

at district level and strengthening the integrated inter-sector program.

3.2. Facilitating program review and monitoring meetings among DHO and PHO

Officers at province level (2 meetings in Banten and West Java)

The annual program review and monitoring meeting will be done for all districts at the

province to identify achievement, bottlenecks and solution for the next year program.

There will be about 62 participants for the meeting in West Java province, which include:

PHO officers

DHO officers

MI extenders

There will be about 24 participants for the meeting in Banten province, which include:

PHO officers

DHO officers

MI extenders

3.3. Facilitating the national level TOT on systems, tools and product specifications

for planning, delivery and monitoring of the program.

MoH staff (as a trainer) will deliver trainings for nutrition officers of PHO staff.

There will be 20 participants from PHO of West Java and Banten (nutrition, MCH, health

promotion, surveillance and pharmacy officers) and MI extenders.

The training will be focus on methodology for training DHO staff on forecasting targets,

procurement of VAC, how to monitor, tracking, correct recording and reporting, regular

supervision of the IFA supplementation program, and on importance of IPC with regards to the

IFA program. Pre and post-tests of training participant will be done during the training.

The distribution of communication materials will be done during the training.

3.4. Facilitating the trainings by the PHO staff to the DHOs staff on systems, tools and

product specifications for planning, delivery and monitoring of the program

Province Health Office staff (as a trainer) will deliver trainings for DHOs staff (nutrition, MCH,

health promotion and pharmacy officers) from 33 districts in two provinces (8 districts in

Banten, and 27 districts in West Java). Total number of participants will be 150 people (132

trainees and 18 trainers).

The training will be focused on how to plan, forecasting targets, monitor, tracking and

recording the IFA supplements, importance of IPC with regards to the IFA program, regular

supervision to Puskesmas and supply chain management. Pre and post-tests of training

participant will be done during the training. MI extender will also be involved in these

trainings.

3.5. Facilitating the trainings by the PHO staff to the DHOs staff on supply chain

management.

Province Health Office staff (as a trainer) will deliver trainings for DHOs staff (nutrition and pharmacy officers) from 33 districts in two provinces (8 in Banten and 27 in West Java). Total number of participants will be 78 people (66 trainees and 12 trainers). The training will be focus on supply chain management of IFA supplementation including

estimated planning, how to handle bottlenecks and improve stock recording system. Pre and

posttests of training participant will be done during the training. MI extender will also be

involved in these trainings.

4. Deliverables

The deliverables are:

1. Timely bound activities progress report, which should be submitted after completion of each activities. The report should cover:

a. Process b. Methodologies utilized that used in each activities c. Regular observations on how the implementation of meetings/trainings d. Key outcomes for each activities e. Conclusions f. Meeting notes g. Copy of facilitator manuals for the trainings h. Copy of training modules for training activities i. Copy of presentations of advocacy meetings/program review meetings j. Copy of contact list of event attendees k. Financial reports for the activities that have been implemented l. Photos/documentation of activities that have been implemented

2. Final activities report which cover:

a) Executive summary b) Process c) Methodologies utilized that used in every activities d) Regular observations on how the implementation of meetings and trainings e) Key outcomes for every activities f) Conclusions m. Annexes, which consist of:

(i) Notes of every meeting conducted (ii) Copy of all facilitator manuals for the trainings (iii) Copy of all training modules (iv) Copy of advocacy meetings and program review of every meetings

presentations (v) Copy of contact list of every event attendees (vi) Financial reports of all activities (vii) Photos/documentation of all activities

5. Management Arrangements

The proposed assignment will be done through the selected agency that will facilitate the above mention activities at district, province and national levels.

MI will provide the technical and financial support through this agency. The activities will also be coordinated together with DHO, PHO and Sub-Division Micronutrient, Directorate of Community Health, MoH.

6. Time Schedule

The duration of activities will be during September 2015 February 2016.

Week

Activities 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Preparation x x x

Advocacy

meeting at

national level

x

Advocacy

meeting at

province

level

x x

Advocacy

meeting at

district level

x x x x x x x x x x x x x

Facilitating

program

review

x x

Facilitating

the national

level TOT

X

Facilitating to

the DHOs

staff on

systems,

tools

x X

Facilitating

the trainings

to the DHOs

staff on

supply chain

x X

Development

of final

report

x x x

7. Qualifications of agency

i. Legally registered in Indonesia ii. Experience in organizing workshops and trainings for health workers.

iii. At least 5 years of experience in managing the workshop and trainings in collaboration with the Ministry of Health including Province Health Office and District Health Office in the field of public health and nutrition.

iv. Experience with nutrition and maternal health programs desirable. v. Competent in written the report in English.

8. Budget of Activities

Total budget for these activities will be CAD 250,000

9. Schedule of Payment

a. Payment 1: 60% of total cost as advance for initiation of activities.

b. Payment 2: 20% of total cost after satisfactory completion of progress report for following activities: advocacy meeting at national level, advocacy meeting at province level, facilitating the national level TOT, facilitating to the DHOs staff on systems, tools, product specification for planning and delivery of the program, and facilitating the trainings to the DHOs staff on supply chain.

c. Payment 3: 20% of total cost as final payment after satisfactory completion of all activities, receipt

of invoice and submission of all deliverables