CFAs: Enhancing Nutrition Monitoring, Evaluation, Research, and Learning in the Health Sector (NuMERAL)

Deadline: 15-Oct-24

The United States Agency for International Development is inviting local organizations to submit applications for the Enhancing Nutrition Monitoring, Evaluation, Research, and Learning in the Health Sector Activity (NuMERAL).

The NuMERAL Activity is a 5-year (2023–2028) project funded by the United States Agency for International Development (USAID) and implemented by RTI International and partners. RTI leads and manages the NuMERAL consortium and works in collaboration with the African Population and Health Research Center (APHRC); International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b); and the University of California, Davis.

NuMERAL’s goal is to fill evidence gaps and enhance nutrition and ECD outcomes implemented through health systems, as well as interventions aiming to improve the nutrition, health, and general well-being of individuals and populations. NuMERAL works with local partners to strategically design, implement, disseminate, and use such evidence to strengthen policies and programs that improve human nutrition at the national, regional, and global levels.

NuMERAL is committed to supporting local research, monitoring, and evaluation, and translating findings to inform country-level and cross-national learning, collaboration, and action across the following three focus areas:

• Mainstreaming nutrition in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) policies and services
• Integrating responsive caregiving and opportunities for early learning into nutrition policies and programs
• Improving assessment and prevention of micronutrient deficiencies and anemia.

Scope

• This Request for EOI (REOI) is designed to fill evidence gaps in the delivery of high-quality nutrition and RCEL services through the health system at scale. NuMERAL is currently seeking EOIs under this REOI to further explore four priority topics:
  • Priority Topic 1: Design, implementation strategies, and evaluation 
    • Over the last decade, significant research advancement has been made on maternal and child nutrition and ECD. This progress has resulted in better guidance on interventions to address malnutrition and support children to reach their developmental potential (Keats et al. 2021; Bhutta et al. 2013). Research efforts are increasingly focusing on how interventions are implemented in the real-world, under non-ideal situations; thus, providing a more genuine portrayal of their effectiveness (Keats et al. 2021).
  • Priority Topic 2: Integrating nutrition and/or RCEL into the health system 
    • WHO defines integration as the management and delivery of services so that clients receive a continuum of preventive and curative care based on their needs across the health system (WHO 2018). In the context of RMNCAH services, integrating nutrition and RCEL refers to delivering interventions through the established service contact points across a broad range of health services, such as integrated management of childhood illness/integrated community case management, child health days, immunizations, and antenatal care services. Integrated interventions combine various strategies and services into cohesive programs, creating synergy and enhancing the overall effectiveness, compared to delivering each service separately. This approach is not only efficient but also serves as a catalyst for improving health outcomes.
  • Priority Topic 3: Impact of nutrition and/or RCEL services on nutrition and/or ECD 
    • Efficacy trials have provided substantial evidence on the positive impacts of direct healthcare nutrition interventions on nutritional outcomes, while RCEL has shown to positively influence children’s socioemotional and cognitive development (Black et al. 2023; Keats et al. 2021). The extent to which the integration of nutrition and/or RCEL services translates to improved outcomes in real-world settings is less well known.
  • Priority Topic 4: Additive and synergistic effects of multiple interventions delivered in the same program 
    • Multiple interventions delivered simultaneously in combination with other services in the same program have the potential to have additive or synergistic effects on nutrition and ECD outcomes (Dulal et al. 2021).

Funding Information

• NuMERAL anticipates issuing two to five subawards with an expected range of U.S. dollar (USD) 50,000 to USD 250,000. This range may be refined after the co-creation process.
• The performance period for each subaward is expected to be up to 24 months.

Types of Research supported under this REOI and illustrative examples 

• Types of research to address priority topics could include but is not limited to the following:
  • Formative research, quality improvement assessments, and participatory action research
  • Operations research, process evaluation, quality improvement/assurance, monitoring and evaluation, local observation, cross-sectional survey intervention mapping, social network analysis, journey mapping, and video observation
  • Cross-sectional or cohort studies, small-scale comparative studies, longitudinal quantitative analyses, longitudinal qualitative analyses, and factorial trials.

Illustrative Research Activities 

• Illustrative examples of research activities are below.
  • Counseling women on optimal diets and other nutrition behaviors during pregnancy and after childbirth is a key recommendation for antenatal and postnatal care services. Despite being a recommended practice, evidence shows counseling does not have wide coverage and quality is variable. Further, for example, non-pregnant women’s dietary diversity data suggests that, in many places, counseling is suboptimal. Quantitative and qualitative methods can include the use of health management information system data, in-depth interviews, and observations of counseling sessions by health providers at the facility and community levels. This primary data can be used to help determine how to best support health workers to ensure nutrition counseling is robust and regularly provided at different touch points during antenatal and postnatal care.
  • Immunization programs are some of the most widely implemented health services. This presents a unique opportunity to incorporate infant and young child feeding (IYCF), as well as RCEL counseling and vitamin A supplementation, into routine immunization schedules. An example learning activity could include formative research to understand implementation research methods to test integrating IYCF and/or RCEL counseling and, when still required, vitamin A supplementation,1 into routine immunization services. This could be answered quantitatively and qualitatively by utilizing continuous quality improvement methods and/or key informant interviews with providers, local authorities, and recipients of services to better understand the critical inputs needed for successful integration, including microplanning, supervision, and follow-up resources. In addition to interviews, client–provider observations could also be conducted to better understand the provision and experience of care.
  • Little is known about the effectiveness of integrating RCEL with nutrition interventions in different contexts. A learning activity could include examining the feasibility and acceptability of integrating responsive care and feeding into an existing IYCF intervention that does not currently include this aspect of nurturing care. This could be done by conducting key informant interviews with providers, local authorities, and caregivers to better understand potential benefits (e.g., caregiver satisfaction, improved nutrition outcomes) and challenges (e.g., provider workload) of including responsive feeding. Necessary inputs could be considered, such as preparation, training, materials, workforce, financial, governmental, and community support, as well as expected impacts on caregiver behaviors or child outcomes.

Geographic Location 

• All applicants must be a local or regional organization (based in a country with a USAID presence). A local organization is defined as an organization that (1) is legally organized under the laws of the same country of the proposed work and (2) has its principal place of business or operations in the same country of the proposed work. Local organizations are required to be registered in the country of operation. Regional organizations (based in a country with a USAID presence) are required to be registered in one or more of the countries they operate in.
• Priority is given to local organizations in USAID’s 18 Nutrition Priority and Nutrition Strategic Support Countries: Bangladesh, Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Guatemala, Haiti, Malawi, Mali, Mozambique, Nepal, Niger, Nigeria, Senegal, Tajikistan, Tanzania, Uganda, and Zambia.
• Organizations based in the following countries are not eligible for funding under this solicitation, but may be eligible under future solicitations: Afghanistan, Algeria, Bahrain, Belarus, Burma, Chad, China, Colombia, Cuba, Curaçao, Djibouti, Ecuador, Egypt, El Salvador, Equatorial Guinea, Eritrea, Guinea-Bissau, Iran, Iraq, Lebanon, Libya, Macau, Mexico, Nicaragua, Papua New Guinea, Peru, Philippines, Russia, Saint Maarten, Somalia, South Sudan, Sudan, Sri Lanka, Syria, Trinidad & Tobago, Tunisia, Turkmenistan, Venezuela, West Bank/Gaza, and Yemen.

Eligibility Criteria

• The REOI is open to the following eligible organizations:
  • Universities or other research or learning institutes
  • Parastatals
  • Community-based organizations
  • Civil society organizations
  • Nongovernmental organizations
  • Private sector companies.

Ineligible 

• The following types of organizations are not eligible to receive funding under this REOI:
  • Political parties, groupings, or institutions, or their subsidiaries and affiliates  Government entities
  • Organizations that appear as ineligible on the System for Award Management (SAM), UN 1267, and/or OFAC/SDNBP lists
  • Organizations that promote or engage in illegal activities or anti-democratic activities
  • Faith-based organizations that are not in compliance with ADS 303.3.28, which is in accordance with Executive Order 13279, Equal Protection for the Laws of Faith-based Community Organizations, and/or whose objectives are discriminatory or religious in nature
  • An organization that refuses to register for a unique entity identifier (UEI)
  • Organizations that are not legally registered in the country of implementation
  • Any entity that has been found to have misused USAID funds in the past 3 years
  • Organizations that are employers of or managed by staff from USAID, RTI, APHRC, icddr,b, or the University of California Davis that work on the NuMERAL Activity, or their immediate family members.

For more information, visit USAID.