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Title: Strengthening quality of outpatient treatment and management of moderate and severe malnutrition at Primary Health Care Centres (PHCs) through an integrated child health and nutrition services approach in Bauchi, Kebbi, Sokoto, and the Federal Capital Territory

USAID’s Integrated Health Program (IHP) invites qualified local entities, Nigerian Non-governmental Organizations Profit and Not-for-Profit), non-governmental professional associations, training institutions and other qualified organizations to submit concept notes and full applications (if shortlisted) with respect to technical, managerial, and other aspects of the program described below.

IHP is seeking interested eligible organizations that have interest in preventing and treating moderate malnutrition without complications and preventing relapse among recovered severely malnourished children using food-based counseling approaches. Illustrative activities may include but not limited to participatory cooking activities, counseling for caregivers and pregnant women, household food production and processing demonstrations for preparing affordable, nutritious foods, year-round using locally available foods. Organizations should reinforce healthcare workers’ use of Infant and Young Child Feeding (IYCF) to counsel caregivers to address active cases of malnutrition treated through out-patient and community-based services.

In 2020-2021, IHP conducted onsite training to increase clinical skills competencies of primary health care workers, including those pertaining to Infant and Young Child Feeding (IYCF) to prevent malnutrition and to screen, assess, identify malnutrition in children through growth monitoring, and to counsel caregivers in correct infant and young child feeding practices. In 2021 and 2022, IHP awarded Phase 1 nutrition grants to local organizations to build the capacity of health workers to implement food-based approaches for the prevention and care of malnutrition. This included identifying locally available and affordable foods and food preparations through positive deviance inquiries of very poor families with well-nourished children in a variety of communities in IHP supported states that support dietary diversity and by demonstrating preparation of healthy and affordable meals for children to prevent malnutrition. In Phase 2, grants will build on previous efforts to strengthen the clinical skills of primary health care workers to not only identify malnutrition but provide an integrated package of services that includes a food-based approach to treat children identified with Moderate Acute Malnutrition (MAM) and uncomplicated Severe Acute Malnutrition (SAM) on an outpatient basis and track their progress through graduation from malnutrition to normal nutritional status.

The aims of IHP’s Phase 2 Nutrition Grants in Bauchi, Kebbi, Sokoto and FCT are to build the capacity of the health workers at the IHP supported facilities to:
1. Manage MAM through an outpatient treatment intervention that includes integrated child health and nutrition services and a food-based approach, thereby reducing escalation to wasting/SAM, and relapse of recovered cases.
2. Improve the outpatient treatment of uncomplicated SAM through the Community Management of Acute Malnutrition approach that includes integrated child health and nutrition services and a food-based approach and RUTF (where available), referring complications to referral hospitals and inpatient stabilization centers and
3. Track the progress in weight and in consumption of a minimum acceptable diet (minimum dietary diversity and minimum meal frequency) among children identified as MAM and SAM through graduation to adequate nutrition status.
Goals and Objectives

To build the capacity of health care workers at primary health care centers, including those recognized as CMAM centers, to effectively treat and track the progress of children under 5 years of age identified as MAM and SAM and prevent relapse among recently recovered malnutrition cases.

Health workers will be trained using a 3 to 4 day training package (5 days in Bauchi and Sokoto with emphasis on CMAM sites with access to Ready to Eat Therapeutic Foods) They will also be mentored to provide a comprehensive package of services to treat moderate acute malnutrition (MAM) and uncomplicated severe acute malnutrition (SAM) in children under five, Including integrated child health services and a food based approach with locally available and affordable food, in each of the project States, the Grantee will strengthen the capacity of PHC Health Care Workers in at least five index primary healthcare centers (PHCs) recognized by the State Primary Health Care Development Agency (SPHCDA) as 1 one PHC per ward in each Local Government Areas (LGAs), or Area Council Health Authority (ACHA) in the case of FCT. IHP with the SMCH SPHCDA and PSM will conduct the analysis to determine which five sites (10 PHC/CMAM sites each in Bauchi) should be targeted for this intervention Selection criteria will include staffing levels, patient volumes, and prevalence of malnutrition in Bauchi and Sokoto in particular, Ready to Eat Therapeutic Foods will be issued and utilized in the treatment of SAM with support from USAID funds.

In the HP-supported states, Grantees will train and mentor healthcare providers by:
i. reinforcing skills previously taught in IYCF and childhood immunization low dose high frequency training (including growth monitoring to assess the nutritional status of children, counseling for dietary diversity, WASH, breastfeeding and responsive care),
ii. building on the IHP Nutrition Grant, phase 1 leanings on dietary diversity using a food-based approach with locally available and affordable foods,
iii. Introducing/strengthening outpatient treatment intervention of children identified as MAM and uncomplicated SAM using an integrated package of child health services, including use of Ready to Eat Therapeutic Foods (for SAM cases, where available) and a food-based approach focusing on building capacity of providers to counsel and teach caregivers to use locally available foods to rehabilitate moderately malnourished children (and even severe acute malnutrition with no underlying complications) in the outpatient setting.
iv. Mentoring providers to integrate into outpatient treatment of MAM and SAM child health services such as routine immunization, treatment of uncomplicated childhood illness, and referral to hospitals and stabilization centers for complicated and severe cases.
v. MAM and SAM children enrolled in this intervention will return weekly for follow up care. Their progress (weight for height Mid-Upper Arm Circumference, dietary diversity and meal frequency) will be tracked weekly until the MAM and SAM child graduates to normal nutritional status. Severe and prolonged cases will be referred to more advanced care as required.

The full guide, RFA, Templates and Instructions for submitting the Concept note can be accessed via this link:

1. Submit a letter indicating interest in applying for any of the Task Orders (TOS). If applying for multiple states, separate submissions is required for each state submission.
2. When applying for more than one state, submit full package of all the requirement for each state.
3. Provide evidence of eligibility as per the requirements.
Other consideration to note while submitting the Concept note:

Only short-listed organizations will be invited to submit a full application.

Please send your completed documents in PDF form as a single file to [email protected] referencing the RFA number or numbers on the subject of your email. The document should not be more than 10MB in size. Sometimes electronic submissions are affected by internal challenges and IT issues; as a result, organizations are advised to plan and ensure submissions are made before the deadline. HP will not be held liable if electronic submissions are not delivered or have other challenges that may render it not readable
Representative Email [email protected]
Programme website

Issuance of this RFA does not constitute an award commitment, nor does it commit Palladium to pay for costs incurred in the preparation and submission

Note: This submission of concept note closes on December 21, 2022 by 5.30pm local time.