Consultancy Services: Implementation Research on Strengthening Capacities of the Community Health Services

When delivered twice a year to at least 80% of children aged 6 to 59 months in countries with high under five mortality and high rates of vitamin A deficiency, Vitamin A supplementation (VAS) can contribute to a reduction of under-five mortality rate by up to 24%.

In Kenya VAS is one of the High Impact Nutrition Interventions (HINI) designed and implemented to control micronutrients deficiencies among children aged 6-59 months and is delivered through three different approaches which include (i) Routine contact points at Health Facility, (ii) integration in campaigns and Malezi bora, and (iii) outreach distributions by volunteers, through community health units, or in early childhood development centers (ECD).

Soil-transmitted helminth (STH) infections are common in Kenya and can affect up to 40% of children aged 12-59 months. This warrants mass administration of deworming treatments. Deworming is one of the most feasible and cost-effective public health approaches to control soil transmitted helminth infections among infants and young children. According to WHO, worm free children have a better nutritional status, grow faster, and learn better. Worm infections are associated with significant loss of micronutrients. In preschool children, roundworms which are the most prevalent STH infection cause significant vitamin A mal-absorption.

For several years, Helen Keller has supported the government of Kenya integrate the delivery of VAS and deworming for children 6 to 59 months. Combining vitamin, A supplementation and deworming has both logistical and health advantages and makes the delivery of both interventions more cost-effective. Multiple models and platforms have been used: outreach, Malezi Bora, ECD.

To achieve Universal health care, the government of Kenya both at national and counties level has invested heavily on community health services to enable households to access basic healthcare and health information. However, since the roll out of the Community Health strategy, the use of Community Health Services to deliver VAS and deworming is not fully exploited.

Helen Keller is planning to conduct an operational study to compare the feasibility, cost and effectiveness of two distribution models for VAS and deworming (VASD) to children 6 to 59 months: over a 2 to 4 weeks period during Malezi Bora and over a 6-months period by Community Health volunteers.

For this purpose, we are looking at a qualified consultant to support the design, implementation, and analysis of the study.

The scope of work

The operational research seeks to compare VASD distribution by CHVs over a semester long period vs. during the Malezi Bora campaign.

The research seeks to answer the following key questions:

• How feasible is it to deliver VASD throughout the year at the Community Health Unit level?
• What is the difference in costs and effectiveness of VASD delivery between Malezi Bora and CHU delivery?
• What are the key steps that should be considered in planning, implementing, and monitoring VASD at CHU level?

To respond to these questions, Helen Keller International in Kenya is recruiting a research consultant who will help to design the research protocol, support validation process and implementation of research.

Specific responsibilities of the consultant

1. Refine and finalize the study protocol
2. Support validation of the protocol with necessary bodies and ethical committee
3. Develop the research micro plan and lead in its implementation
4. Take lead in data collection and analysis
5. Prepare research report and article for peer review publication

The Consultant must possess the following qualifications:

1. Minimum master’s degree in nutrition or public health, statistics or related
2. Demonstrated experience in conducting operational research on health systems + costing studies + cross sectional surveys
3. Good analytical skills

Time frame

This consultancy is expected to commence in June 2021 for a 12-month period and is expected to take around 60 days.