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For every child, health

Recent data on the prevalence of multi-micronutrient deficiencies among women and children in Tanzania except for vitamin A, Iron, and iodine is lacking. The last comprehensive surveys were carried out nearly a decade ago. Since then, Government and partners have gradually increased investments to control micronutrient deficiencies, including the elimination of iodine deficiencies through universal salt iodization, national vitamin A and deworming campaigns, and routine micronutrient supplementation for pregnant and lactating women. There are no data on other micronutrient deficiencies such as Zinc and vitamin D. Data is critical to monitoring the impact and coverage of these programs, and importantly, inform the development of updated national policies and guidelines, including a comprehensive micronutrient deficiency control strategy. Along with the upcoming TDHS survey planned for 2021-2022, Government and partners have agreed it would be an opportune time to carry out a new national micronutrient survey, which would also provide regional level representative data for key micronutrient indicators. In addition, the food samples testing component of the survey will provide population-level information on the quality of fortification and estimated contribution on nutrients intake from the large-scale food fortification program in Tanzania rolled out in 2013. Funds for this national survey have already been mobilized by UNICEF. The national survey will integrate components to assess the anthropometry/nutritional status of targeted populations, biomarkers

How can you make a difference?

UNICEF is committed to supporting the Government of Tanzania to support the operationalization of the National Multisectoral Nutrition Action Plan (NMNAP I) 2016-21, and the upcoming NMNAP II 2021-26. To track progress on implementation of NMNAP UNICEF is supporting the Government of Tanzania on strengthening the multisectoral nutrition information system (MNIS) at the national, regional, district, and community level. The MNIS includes three key components: i) Surveys; ii) Routine information system; iii) Review and learning. Annually, multisectoral partners for nutrition meet at the Joint Multisectoral Nutrition review (JMNR) to review the progress of the NMNAP at the output and outcome level, through its Common Results, Resources, and Accountability Framework (CRRAF). Recommendations from the JMNR 2019, included the need to conduct a micronutrient survey within the TDHS 2020/21. The micronutrient survey is needed to generate new data as the last time the micronutrient survey was conducted was during the 2010 TDHS. There is a renewed interest within the government of Tanzania in reducing micronutrient deficiencies particularly in adolescents and women of reproductive age and more recent data on the burden and trends of micronutrient deficiencies are needed. This will be the first TDHS survey in the region to also incorporate fortifiable food sample testing and assess the quality of food fortification and coverage at the population level.

TDHS will be coordinated by the National Bureau of Statistics (NBS) in close collaboration with the Tanzanian Food and Nutrition Center (TFNC), especially on the micronutrient part. Any National level survey is a large undertaking, and a micronutrient survey requires specialized equipment, logistical arrangements, and expertise to ensure the integrity of specimens collected and laboratory analyses conducted. UNICEF, therefore, requires strong technical support to support the NBS and TFNC to implement the survey, coordinate all aspects of the laboratory activities for the survey, in close collaboration and oversight from the Centers for Disease Control and Prevention (CDC) team.

MAIN OBJECTIVES, DELIVERABLES AND TIME FRAME 

Main activities:
The objective of this consultancy is to technically oversee and provide the technical leadership on the laboratory aspects of the micronutrient survey, including supply management, field logistic arrangements and organization for training, supervision, and samples collection, shipment, and processing including QA/QC, as well as analyses and reporting. Further, the laboratory coordinator will contribute to report writing and compilation.

Specifically, the laboratory coordinator will:

• Meet with NBS and TFNC survey leads regularly (weekly if necessary), maintain a list of time-bound action points with responsible persons identified.
• Support the focal point, together with TFNC and NBS survey leads, for the survey to liaise with CDC and other key stakeholders.
• Coordinate laboratory-related activities at the field level, satellite laboratories as well as central laboratory at TFNC, including backup laboratories.

The objectives of the micronutrient survey to measure the micronutrient status of young children and women including iron, vitamin A, folate, and iodine.

Main objectives

The purpose of the laboratory coordinator will be to support TFNC with the organization and implementation of the laboratory and samples management activities for the national micronutrient survey. More specifically the consultant will work together with technical specialists in NBS, MOHCDGEC, TFNC, and UNICEF to:

• Ensure procurement / availability and management of supplies and equipment necessary for the survey (forms, tools, field-level tests, laboratory assays, and sample archiving) is conducted in a timely manner including communicating with laboratories involved on specifications for, quantities needed, and acquisition of adequate supplies for training, pretest and the main survey.
• As shipments of supplies for the TDHS 2021 micronutrient survey arrive in-country, ensure shipment(s) are cleared from customs in a timely manner and transported to an identified locked room for storage. Be responsible for and take ownership of the supplies – control access to the room as much as possible and make sure that any items needing to be refrigerated are put into the refrigerator upon receipt.
• Finalize the survey manuals and timeline including the preparatory activities, training, field samples collection, laboratory analyses, report writing, and presentation of laboratory results in collaboration with other partners including ICF, CDC, and USAID.
• Conduct assessments of potential intermediate laboratories that may be used for temporary storage of biological specimens and food samples during the survey, and ensure that there is enough space in the selected intermediate laboratories in order to properly store biological specimens at the correct temperature (cold-chain) and food samples.
• Determine where biological samples can be processed at the end of the day in each cluster; and identification of laboratory facilities or make-shift laboratories (e.g. health center) for biological samples processing during the survey
•  Support pre-test (field test) to validate the questionnaire, methodology, sample collection, analyses, data entry, and recording. Including working with the trainer(s) to get all the supplies inventoried, organized, accounted for, and tracked.
• Organize a standardization test for the biomarkers and food samples testing part of the survey to ensure high-quality micronutrients, anemia, and food fortification data collection.
• Support TFNC supplies management (field samples management, peripheral as well as for central laboratory) ensuring all supplies are in place for the survey – this includes ensuring a final list of supply needs as per the final protocol, ensuring orders are placed, and following up on their status and alerting management to any delays/supply issues.
• Facilitate training of 1) the health technicians (phlebotomists) and laboratory technicians who will be drawing venous blood and processing, storing and transporting survey specimens, of 2) team leaders, coordinators and drivers to facilitate hands-on experience with cold-chain transport of biological specimens, transport of food samples, and transmittal sheets, and of 3) staff at TFNC to receive and inventory biological specimens and food samples arriving from the field for storage and analysis
• Support planning to deploy teams of data and sample collectors in different parts of the country indicating the location/cluster and changeover dates for each team.
• Supervise teams on the ground to ensure the quality of sample collection and transfers to laboratories for processing and testing on daily basis and provide corrective feedback as necessary to teams.
• Ensure appropriate quality assurance and quality control, availability, and safekeeping of equipment for field sample collection, processing, and laboratory analyses for all laboratories that will be handling TDHS micronutrient survey samples.
• Provide oversight on logistics for samples collection, processing, transport and receipt of biological specimens and food samples, completion of transmittal sheets and forms, and ensuring that biological specimens (cold chain) and food samples are properly stored.
• Institute appropriate waste disposal protocol and ensure that biohazard waste is properly disposed of in the field as well as across all laboratories involved.
• Ensure accurate documentation of survey process related to samples management and laboratory analyses, including constraints, difficulties, and potential biases identified including use of photographic evidence for use for visibility and donor reporting and
• Communicate the progress of the survey (and actions outlined above) with the TDHS coordinator and over-seeing organizations on a weekly basis.
• Participate in the analysis and interpretation of the results of the survey with technical specialists from UNICEF, NBS, and TFNC and contribute to the final report of the national micronutrient survey.