Supply Chain Assessment for Zinc and Low-Osmolarity ORS (Lo-ORS) under the Drug Revolving Fund (DRF) – Kano and Sokoto States, Nigeria

Terms of reference

1.0 Background

Nutrition International (NI) is a global organization dedicated to delivering proven nutrition interventions to those who need them most. Working in partnership with countries, donors, and implementers, our experts conduct cutting-edge nutrition research, support critical policy formulation, and integrate nutrition into a broader development agenda. In more than 60 countries, primarily in Asia and Africa, NI nourishes people to nourish lives.

Childhood diarrhoea remains a critical threat to child survival in Nigeria, accounting for approximately 10% of deaths in children under five. While the national prevalence stands at 12.9% (approximately 13%), state-specific variations indicate a much heavier burden in the north-western states. The situation is particularly acute in the focal states of this intervention, though there have been notable improvements. According to the 2024 National Demographic Health Survey (NDHS) data, Sokoto State records a prevalence of 23.2% and Kano State records a prevalence of 17.9%^[1]. This represents a significant reduction compared to the 2018 NDHS data, which reported an alarming prevalence of 37% in Sokoto State and 20.7% in Kano State^[2].

Despite these improvements, the burden remains high, particularly in Sokoto where the prevalence is nearly double the national average. Furthermore, the 2024 data highlights critical gaps in careseeking behavior in these regions. In Sokoto, advice or treatment was sought for only 35.7% of children with diarrhoea, while in Kano, the rate was 44.9%, both of which fall below the national average of 48.9%^[3]. The high under-5 mortality rates in these states – 176 per 1,000 live births in Sokoto and 144 in Kano^[4], underscore the urgent need for continued intervention, focusing on both the prevention and the scaling up of effective treatment protocols.

Diarrhea is a recognized cause of poor nutrition among children, particularly in prolonged cases due to nutrient loss. Conversely, pre-existing malnutrition prolongs diarrhea and increases mortality risks. To break this cycle, Nutrition International is implementing the project “Improve Childhood Diarrhoea Treatment Outcome in Northern Nigeria” in both Kano and Sokoto. The project aims to reduce under-five mortality by focusing on three key areas: improving quality of care by enhancing the capacity of health workers in treatment and counselling, increasing care seeking behavior by promoting prompt care-seeking among caregivers and improving supply chain

by strengthening the Drug Revolving Fund (DRF) schemes to enable reliable, affordable, and continuous access to these life-saving commodities.

1.1 Supply Chain Context in Kano and Sokoto

Effective management of health commodities is pivotal to the success of this intervention. Both states are currently navigating the transition from donor-supported, parallel supply chains toward sustainable, government-led systems.

• Kano State Context: A significant policy shift occurred with the state’s adoption of the National Health Product Supply Chain Management (PSM) Strategy^[5] 2021-2025 in May 2021. However, a maturity assessment conducted by the Federal Ministry of Health (FMoH) graded Kano’s supply system as “under level 3,” out of the 5 maturity levels^[6], indicating it is “maturing but not ready to integrate” fully with public health programs. This is because while the operational mechanics of buying and selling medicines are active, the system lacks the integrated data visibility and institutional strength required for Stage 4.  Currently, nutrition supply chain activities are largely managed by non-state actors (NSAs), creating fragmentation and limiting state visibility into commodity data.
• Sokoto State Context: Similar to Kano, Sokoto faces challenges in commodity security and last-mile distribution. The project seeks to support Sokoto in strengthening its financial model, DRF legal framework, procurement systems and Drug Revolving Fund (DRF) to ensure that essential commodities like Zinc and Lo-ORS are consistently available in health facilities, reducing reliance on ad-hoc external support.

1.2 Rationale

While essential health commodities are available through the DRF mechanism in Kano and Sokoto States, persistent inefficiencies in supply chain operations, data visibility, and system sustainability continue to affect reliable last-mile availability. Variations in governance practices, stock management, reporting quality, and financial flows pose risks to the long-term performance of the supply chain. A focused assessment is therefore necessary to examine efficiently and sustainably the existing system functions, identify operational bottlenecks across the end-to-end supply chain, and generate evidence-based recommendations to strengthen system performance and resilience without duplicating commodity financing mechanisms.

The assessment will provide a structured understanding of system strengths and weaknesses and guide actionable reforms to improve commodity security and health service delivery outcomes in Kano and Sokoto States.

2.0 Objective

To assess state-level supply chain governance, operations, and financing mechanisms for Zinc and Lo-ORS, and identify actionable reforms to strengthen DRF-managed commodity availability in Kano and Sokoto States.

2.1 Specific Objectives

1. Assess the policy, leadership, and accountability structures responsible for guiding and coordination of the management of the state health Zinc and LoORS supply chain and DRF, including roles and coordination among state institutions, LGAs, and implementing partners.
2. Examine supply chain operational performance (forecasting, procurement, storage, distribution, inventory and last-mile delivery) for Zinc and Lo-ORS within the DRF system.
3. Analyze financing mechanisms and DRF functionality, including cost recovery, fund rotation, pricing, replenishment to determine the sustainability of Zinc and Lo-ORS supply within the revolving fund model.

• Assess human resources capacity and data management systems for forecasting, quantification, stock monitoring, reporting, and use of logistics data for decision making including linkages with LMIS and HMIS/DHIS2 where applicable.
• Identify system bottlenecks and root causes of stock-outs, delays, and inefficiencies affecting commodity availability at state, LGA, and facility levels.
• Generate practical, state-specific recommendations to strengthen governance, operations, and financing, and improve DRF performance and support sustainable Zinc and Lo-ORS commodity availability in both states.

3.0 Scope

The assessment will be conducted in Kano and Sokoto States and will cover:

• State-level institutions (State Ministry of Health, State Primary Health Care Management Board, State Ministry of Budget and Economic Planning, State Drug Management Agency (DMA), Drug and Medical Consumables Supply Agency, Logistics Management Coordination Unit, Hospital Management Board, where applicable) and Implementing Partners Supporting Supply Chain (UNICEF, CHAI, Solina, Global Fund, FCDO, etc.).
• Selected Local Government Health Authorities implementing DRF and Zinc–Lo-ORS intervention.
• Selected Public primary health care facilities participating in the DRF.

The assessment will focus on Zinc and Lo-ORS as tracer commodities but will consider broader system implications for essential medicines management.

4.0 Methodology

This assessment will adopt a mixed-methods approach, combining desk review, key informant interviews (KIIs), and field assessments to comprehensively examine the efficiency, resilience, and sustainability of Kano and Sokoto states health supply chain systems.

The methodology will include:

• Desk review of relevant national and state-level supply chain policies, strategic plans, guidelines, operational documents, previous supply chain assessments, stock management records, and financial and DRF-related reports.
• Key Informant Interviews with sub-national stakeholders across relevant Ministries, Departments, and Agencies (MDAs), including health, finance, and supply chain oversight institutions  
• Field visits to service delivery points across all senatorial zones, including interviews with health facility supply chain staff and Facility Managers (Officers-in-Charge) etc.
• Site assessments of central and zonal warehouses to review storage, inventory management, and distribution practices.
• representative of all LGAs, health facilities, and warehouses across both states to ensure coverage of urban and rural areas, high- and low-volume sites, and diverse stakeholders.  
• Triangulation will be achieved by cross-validating findings from desk reviews, KIIs, and field visits, systematically comparing policy documents, stakeholder perspectives, and direct observations to strengthen reliability and reduce bias.

4.1 Key Assessment Areas

Governance and Institutional Capacity

• Review of state-level supportive and unsupportive policies, guidelines, strategies, and regulatory frameworks guiding supply chain management.
• Assessment of supply chain leadership, coordination mechanisms, and oversight structures. • Review of DRF governance arrangements, coordination mechanisms, and accountability structures.
• Assessment of the alignment of state supply chain systems with the National PSM Strategy (2021–2025).

Procurement and Financing (DRF)

• Assessment of state health budget trends over the last five years, with emphasis on DRF financing levels and allocations for Zinc and Lo-ORS procurement.
• Review of procurement processes and practices for Zinc and Lo-ORS.
• Analysis of pricing structures, mark-ups, cost-recovery, and commodity affordability.
• Examination of DRF capitalization, fund flow mechanisms, and replenishment cycles.
• Assessment of financial accountability, transparency, and fidelity to DRF guidelines.
• Identification of opportunities for innovative financing and long-term sustainability of the DRF.

Inventory Management

• Quantification and forecasting practices.
• Stock availability, stock-out patterns, and buffer stock management.
• Reporting, ordering, and resupply processes.

Warehousing and Storage

• Storage capacity and conditions at state, LGA, and facility levels.
• Adherence to Good Storage Practices (GSP).
• Stock management practices, including FEFO compliance.

Distribution and Last-Mile Delivery

• Distribution models, delivery frequency, and logistics arrangements.
• Effectiveness of last-mile delivery mechanisms.
• Challenges affecting timely and reliable commodity availability at health facilities.

Logistics Management Information Systems (LMIS)

• Flow and use of logistics information across levels.
• Availability and utilization of stock records, requisition and issue forms, and reporting tools.
• Reporting rates, timeliness, and frequency.
• Performance of key indicators, including stock-out rates, lead times, distribution cycles, and facility-level supply reliability.
• Degree of integration with, or parallelism to, national LMIS platforms.

Organizational Support for Logistics (Human Resources and Capacity)

• Staffing levels and competencies for supply chain functions at all levels.
• Training, mentorship, and supportive supervision mechanisms.
• Availability and use of tools, job aids, guidelines, and standard operating procedures.

4.2 Data Analysis and Validation

Following data collection, qualitative and quantitative data will be systematically analyzed to generate preliminary findings and actionable recommendations. A stakeholder validation and consensus-building meeting will be convened in each state to review findings, obtain feedback, and agree on priority recommendations and next steps.

4.3. Ethical Considerations and Approvals

Prior to commencement of data collection, formal approvals and authorization letters will be obtained from relevant state authorities in Kano and Sokoto States, specifically the State Ministry of Health, Ethical principles guiding the assessment will include:

• Informed consent: All key informants will be informed of the purpose of the assessment, the voluntary nature of participation, and their right to decline or withdraw at any time.
• Confidentiality and data protection: Information collected will be treated confidentially. No individual-level attribution will be made in reports, and findings will be presented in an aggregated and anonymized manner.
• Data security and ownership: All documents and datasets generated through this assessment are the property of Nutrition International and will be securely managed in line with NI’s data protection and information security policies.
• Respect for institutions and context: The assessment will be conducted with due respect for government systems, institutional hierarchies, and state-specific policies and procedures.

5. Key Deliverables

• Inception Report outlining objectives, scope, methodology, assessment tools and work plan.
• State-specific supply chain assessment reports (PowerPoints, word documents) detailing findings from all assessment areas and recommendation roadmaps (Kano and Sokoto)
• A consolidated summary report highlighting cross-cutting findings
• Stakeholder Validation Workshop – Presentation of findings to government, partners, and stakeholders and opportunity for feedback, consensus building, and refinement of recommendations.

Deliverable	Format	Deadline	Note
Inception report	Word/PDF (max 15 pages)	2 weeks after contract signature	Includes tools & workplan
State Specific supply chain assessment reports (Kano & Sokoto)	Word/PDF (max 40 pages each)	4 weeks after field date collection	With executive summary
Consolidated summary report	Word/PDF (max 15 pages)	2 weeks after final review and feedback	Cross-cutting findings
Stakeholder Validation Workshop Presentation	PowerPoint	1 week after consolidated report approval	Presented to NI & state stakeholders

NB: All data and reports shall be the exclusive property of NI.

5. Submitting the Proposal

Consultant or Consulting Organization is expected to submit to Nutrition International a proposal (ideally not more than ten pages – excluding Annexes, team members’ resumes, previous reports, description of roles, timeline, and the financial proposal), which should have the following outline:    

     I.     Background of organization   

• Summary of the mission and mandate of the organization.   
• Description of the organization’s relevant experience in delivering programs or projects that included gender equality outcomes and/or activities (including links to relevant reports if available).
• Technical implementation plan (max 10 Pages) detailing  
  • Rationale and Context for the work to be carried out under the consultancy.    
  • The consultancy’s Overall and Specific Objectives. Describe the proposed approach including a workplan with activities and timelines and milestones.
  • Proposed data collection methods including specific methods to be used (desk reviews, KIIs, facility and warehouse assessments) and the rationale for their selection, etc.) should be clearly identified and their accompanying sample tools (e.g. desk review checklist, questionnaires, interview guides etc.) submitted.
  • Proposal should describe the data management approach, including procedures for conducting, recording, transcribing and storing qualitative and quantitative data. Where interviews are to be recorded, the approach to transcription should be specified.  
  • Proposed sampling and clear analysis plan, detailing analytic methods (e.g. thematic analysis for qualitative, etc.) and any software to be used (e.g. NVivo or equivalent)
• Qualifications of the key personnel of the team  This shall include: 
  • Resumes of each of the key team members (up to 3 pages per resume of one Lead Consultant and Supporting) with:   
  • Lead consultant should have an advanced degree (master’s or higher) in Public Health, Health Economics, Pharmacy, Supply Chain Management or related fields.
  • Minimum of 10 years of progressive experience in health systems strengthening, supply chain management, or pharmaceutical logistics.  
  • Proven track record in conducting largescale assessments, evaluations, or audits in the health sector including references.
  • Experience working with government agencies, donor organizations, and international NGOs in Nigeria or similar contexts.
  • Demonstrated expertise in Drugs Revolving Fund (DRF) including Drugs Management System, Price and Pricing Policy, Financial Management System & Internal Market Operation.
  • Familiarity with LMIS and other digital health platforms.
  • Strong knowledge of governance frameworks, accountability mechanisms, and policy development.
  • Effective communication and report writing skills, capable of producing high quality technical documents.
  • Familiarity with Nigeria’s health system, particularly the operational realities of Kano State.
  • Understanding of local governance structures, cultural dynamics, and political economy influencing supply chain performance.
• A description of roles and responsibilities of each of the team members (up to 2 pages), indicating their level of effort and aligning with the proposed cost plan. V. Financial Proposal (up to 2 pages):  

Submit a Financial Proposal in a separate file detailing:

• Breakup of all activities, outputs and deliverables.
  • Fees should be inclusive of all insurance, tax, and standard business overheads.   

Based on these Terms of Reference, applicants should submit a proposal and support documents by February 12^th , 2026, to [email protected] 

Annex 1: Draft Budget Indicative

Budget Line Item	Estimated Cost (NGN)	Notes
Ethical Approval		State level Ethical Approvals
Personnel Costs (daily rate x 30 days)		Lead assessment and reporting
Field expenses		Travel, accommodation, Field visits to Kano and Sokoto and coms related expenses
Stakeholder Meetings and Validation		Venue, refreshments, logistics in Kano and Sokoto

Annex 2: Timelines (Indicative)

S/N	Activities	Timeline
1.	Inception Meeting
2.	Tools development and Review
3.	Entry Meeting with Stakeholders
4.	Desk review of some documents (policies, laws and guidelines)
5.	Stakeholders mapping
6.	Data Collection
7.	Data Analysis and Preliminary Report Submission
8.	Validation meeting with key stakeholders
9.	Final Report Writing

---

[1] Federal Ministry of Health and Social Welfare (FMoHSW) et al., Nigeria Demographic and Health Survey 2024 (Abuja and Rockville: FMoHSW, NPC, and ICF, 2025), p. 273.

[2] national Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

[3] Ibid FMoHSW, NPC, and ICF, NDHS 2024, 10.5.1.

[4] Ibid FMoHSW, NPC, and ICF, NDHS 2024, chap. 8.

[5] Federal Ministry of Health (FMoH), National Health Product Supply Chain Management Strategic Plan 2021– 2025 (Abuja: FMoH, 2021)

[6] Nigeria Supply Chain Integration Project (NSCIP) and FMoH Department of Food and Drugs Services, Annual National Supply Chain Maturity Assessment Report (2024–2025 Update) (Abuja: Federal Ministry of Health, 2025).

You are advised to please read carefully, the guidelines in the TOR and to respond in the prescribed format.  

Please submit your proposal with relevant documents to [email protected] only not later than Thursday 12^th February 2026 before 11:59PM deadline for submission.

For further enquiries or clarification, please write to [email protected]  on or before Tuesday 10^th February  2026.