Save the Children International, Somalia
Community health and social accountibily program (CHASP) in Somalia
Terms of Reference for Mid Term Review (MTR)
The purpose of the MTR is to conduct a review and analysis of the current strategies, approaches and other aspects of the CHASP program delivery modality in order to facilitate quality programme implementation, evidence-based programming and informed decision-making process.
CHASP project has been active since May, 2017. The overall objective of the project is to ‘increase utilization of quality Reproductive, Maternal, New-born, Child Health (RMNCH) services which are accessible, acceptable, affordable and equitable through provision of Essential Package of Health Services (EPHS). The project is implemented in 10 districts in the Puntland, Jubaland and Galmudug states of the Federal Government of Somalia. The objectives are expected to be achieved through the following outcomes:
Outcome 1: Evidence base of innovative solutions to inform replication and advocacy established
Outcome 2: Essential Package of Health Services, including nutrition, family planning and reproductive health, delivered to women and children.
Outcome 3: Health governance and management structures strengthened
Outcome 4: Community ownership, accountability and demand for health services enhanced
The project builds on and adapts Save the Children’s decentralised approach as used in the Karkaar Region of Puntland as part of the DFID-funded CHANGE programme (Community Health and Nutrition through Local Governance and Empowerment) whereby the decentralized system for the delivery of health care services empowers district authorities and communities while maintaining the support, supervision and accountability role of the regional and national authorities; as well as ensuring the provision of the Essential Package of Health Services (EPHS) across all four tiers of service delivery, complemented by a strong community level engagement component, with inbuilt flexibility for humanitarian response if/when needed. The project also builds on achievements made under the Joint Health and Nutrition Program (JHNP) and ensures the continuation of life-saving services to vulnerable populations.
This project is being implemented in seven districts of Bari region, and the other three districts are Adado in Galgadud, and Afmadow and Kismayo in Lower Juba. With support from the Swedish International Development Cooperation Agency (Sida) and the Swiss Agency for Development and Cooperation (SDC), implementation of project activities is done by Save the Childen International (SCI) and Médecins du Monde (MDM) with the Ministry of Health.
The results framework of the program which started in early 2017 was updated in March 2018 based on the information received from a baseline household survey and facility assessment. The change process was also informed following an inclusive and participatory consultation process involving partners and field level staff of SCI. This MTR was agreed on as a deliverable as part of the contractual agreement between SCI and Sida to have an independent review of the project implementation. As this programme is an example of adaptive programming this review will provide insights and recommendations for adaptions.
Objectives of the Mid-Term Review
This MTR aims at conducting a process evaluation that will examine, inform and improve the quality of programme implementation., with the following specific objectives:
To appraise the relevance and appropriateness of the current programme in its different contexts
To assess whether evidence generation activities are innovative and appropriate for the contexts, as well as effective and supportive to the project and the wider policy and practice
To assess whether the capacity of health facilities in terms of infrastructure, equipment and personnel has increased during the programme period, and whether the supported health facilities appropriately support and complement the health system in the concerned contexts
To assess whether and how the capacity of regional and district level of MOH and community based structures has increased during the programme period, as well as its relevance to health systems strengthening in the areas of concern
To assess how knowledge, attitudes and practices for health, nutrition and hygiene have improved during the programme period, and their influence on programmatic adaptions to the specific contexts under consideration.
The MTR questions will mainly focus on how well the CHASP interventions are being implemented, and how effectively contributing for the improvement of health systems and for the well-being of the population in every context concerned. The following questions shall be answered, but are not limited to
What is the a) Relevance, and b) Appropriateness of the the project in its different contexts?
What are the strengths, weaknesses, risks and opportunities associated with the current program implementation approaches?
What are the trajectories of change in the capacity of regional and district level of MOH, community based structures to manage a functional health system in the areas of concern? What benefits is this programme bringing to the local public health system in every concerned context, in the opinion of the district and regional authorities?
Are the best practices or lessons learnt reported for year 1 appropriate for the health system in the project contexts? Why or why not?
Proposed methodology and approach
Proposed CHASP MTR Strategy
Qualitative and participatory methods will be used in this process evaluation Evidence will be supported by providing full transcripts of informants responses in annex to the evaluation report. The focus will be to obtain an indepth understanding of the relevance and effective system-building role of the CHASP programme in the 10 districts from the perspectives of the relevant stakeholders including MoH representatives, patner staff, selected beneficiaries groups (boys, girls), donors, SCI implementing staff and other sector-relevant actors in the concerned districts. Below are possible strategies to be used for collecting the project’s process level information;
Interviews- Open ended questions regarding feelings, knowledge, opinions, experiences, perceptions on the proposed project strategies.
Focus group discussions (FGDs)
In-depth interviews with key or other community members
Observations from fieldwork (heath facilities) descriptions of activities
Key informant interviews with MOH and SCI members
In addition to this primary data collection, the review shall draw on project documents, reports from monitoring visits and the baseline study conducted in late 2017.
Reviewers and Participants
This review will be done by an external consultant with support from SCI. SCI supports will involve logistics of data collection and site visits, providing background information, and managing any primary data collection that is deemed necessary by the consultant.
The Research Coordinator CSS of SCI Somalia will oversee the process of supporting the external reviewer(s) and draw on MEAL managers in South central and Puntland, and the SCI programme team. The project director, SCI senior managements and SC members will review and provide feedback to ensure quality of the report, and the findings are relevant to programming.
Government stakeholders that will be involved in the process are MoH at State level Ministries and representative Federal Minstry of Health respectively.
4.3. Timeline: The expected timeframe of this review is 30 working days over two months, and the draft report will be submitted within two months of signing contract. SCI will collate feedback from stakeholders (SC members, donors and the government), and share with the consultant witin two weeks of receiving the draft. The final report must be submitted after one week of receiving the feedback.
4.4. Quality assurance
SCI’s quality assurance process includes checks at various stages of the MTR. As a first step the external reviewer(s) will take part of SCI’s Evaluation Report Quality Assessment Tool to guide the development of review methodologies (also ensuring that ethical principles and child safeguarding guidelines and understood and followed throughout the review process). The Inception report will be reviewed by SCI and SC Sweden, enabling feedback and dialogue with the external reviewer(s) on the direction and progress of the review and allowing for adjustments in approach if necessary and relevant. The quality of the final reports delivered under this TOR will be endorsed by team members from SCI, Sida and SDC through a detail review of the findings and recommendations as well as the methodological soundness behind those findings.
4.5. Ethical Consideration: The review objectives will be clearly explained to all the respondents prior to gathering any form of information from them. Written consent of the respondents will be taken before collecting information where possible. The team will further be required to follow the SCI ‘Child Safe-guarding Policy’ and ‘Do No Harm’ policy through the review process. The team will also need to comply with ethical considerations during information collection process with the girls and boys.
4.6. Work Plan: The detailed work plan for the review will be finalized by the first week of August, 2018 in consultation with the program team after a consultant is identified to undertake this MTR. The roles and responsibilities to execute the process will be determined based on consultation with SC-Sweden.
Scopes of work:
The scopes of work will be based on the objectives and key deliverables as specified in this ToR.
An inception report outlining the approach and methodology of the MTR
A draft report that addresses the expectations stipulated in the objectives and key questions of the MTR
A debriefing presentation for Save the Children International, where the overview of the findings and the recommendations will be discussed
Final evidence based report as per objectives and MTR questions stipulated in the ToR and following the reporting outline incorporating all feedback, suggestions and recommendations from Save the Children International.
Presentation of the final report to steering group meeting after sharing the report with the group members with 2 weeks to review
Asessment of application
Interested consultant or firms shall apply over email or by hard copy submission at SCI office by 26th July, 2018. After reviewing the technical and financial aspects of the applications, shortlisted candidates will be requested for an interview. The contracting shall be done by 6th August, 2018.
The final report will contain the following elements:
List of abbreviations
Executive summary (Not exceeding 2 pages)
Design and Methodology
Process of the review
Reliability of Data
Findings & Analysis based on each part of the objectives
Challenges and probable solutions
List of references
At least masters degree in public health or relevant disciplines
2 years of experience in similar research-focused positions
Knowledge and demonstrated experience of designing and leading project review
Demonstrated ability to think critically and strategically in giving practical advice from project reviews
Fluency (verbal and written) in English and Somali is essential
The proposal may include a team instead of an individual. If a team is proposed, their roles should be specified.
Interested candidates, firms and companies should submit their application to firstname.lastname@example.org The applications should include a proposal, estimated budget for the entire work including consultancy fees per day and availability.
All applications MUST be submitted by close of day 26th July 2018 to be considered for the assignment.
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