Somalia: Evaluation of Mother and Child Health Care Programme

1. INTRODUCTION

These Terms of Reference (ToR) serve as a request for proposals from individual consultants who are interested in conducting an end of project evaluation of SOS CV Somalia’s “Mother and Child Health Care” programme in South Central Somalia. Details regarding contents of proposals and submission procedures are explained herein.

SOS Children's Villages International is the umbrella organization of more than 130 affiliated national SOS Children's Village associations worldwide. SOS Children's Villages is a non-governmental and non-denominational child-focused organization that provides direct services in the sector areas of care, education and health for children at risk of losing parental care, and those who have lost parental care. The organization also builds the capacity of the children's caregivers, their families and communities to provide adequate care.

SOS Children's Villages Somalia is a non-governmental social development organisation that has been active in the field of children's rights and committed to children's needs and concerns since 1985.

During the intervening years, the Organization has continuously expanded its programmes and currently operates in Mogadishu and Baidoa of South Central Somalia and Hargeisa, Berbera and Sheikh in the Southwest zone of Somaliland.

a) Context of the project (political, natural, etc):

For over two decades, the people of Somalia have faced prolonged and deadly conflict due to the absence of a fully functioning government, widespread economic collapse and loss of livelihoods, recurrent natural disasters including drought and flooding, and resultant famine and food insecurity. In this environment, people are extremely vulnerable to malnutrition, communicable diseases, maternal and child morbidity and mortality, gender-based violence (GBV) and a number of other health and social problems.

Public health services in most of South Central Somalia have been in a dire state since the collapse of the central government in early 1990s. In a region that is vulnerable to extreme shocks such as drought and famine exacerbated by insecurity and civil conflict, basic health services are inadequate. Drought conditions, disease outbreaks, displacement, refugee returns and food insecurity continue to drive humanitarian needs in Somalia. Furthermore, funding to health facilities in the areas have decreased over the years making SOS CV Somalia one of the few remaining primary healthcare providers in the region causing strain to the implementation of activities in the areas.

SOS Children's Villages International (SOS) Somalia office has been receiving funding from ECHO to support its Maternal and Child Health Program which has been implemented in Somalia since 1991. The project has built upon the successes achieved through the years in both Mogadishu and Baidoa and more recently in Badbaado IDP camp to provides health, nutrition, and protection services to Internally Displaced Persons (IDPs), returnees, refugees and host communities in the aforementioned target areas. SOS CVI has been delivering health care to mothers and children in Somalia, reaching over 200,000 people annually.

b) Project Overview:

The health of the Somalia people remains in a critical situation with some of the worst health indicators in the world. SOS has tailored its interventions to meet the specific maternal and child health needs in the community, in an attempt to reduce the high maternal and child mortality rates. The principal objective of the programme is to improve health care for women and children in Somalia, while the specific objective is improved primary and secondary health care that aims to reduce morbidity, mortality and disability. This is being achieved through basic and comprehensive maternal, reproductive, neonatal, child health, communicable disease surveillance and control, first aid and care of critically ill and injured, treatment of common illness HIV and STIs. In 2016, the programme has reached 237,487 beneficiaries living in the program catchment area and its surroundings.

A Maternal and Child health facility was opened in Mogadishu's Heliwa District in 1991 which SOS CV has been running continuously despite the start of the civil war in the same year while also maintaining operations in the rest of the country. The maternal and child health facility provides life-saving health services to over 220,000 patients every year. The facility is in an area which has been regarded insecure for many years and SOS remains to be the only one providing lifesaving services for almost a half million people living in northern part of Mogadishu. The facility provides life-saving, quality health care including specialized care such as comprehensive emergency obstetrics, and new-born care, outpatient and inpatient services.

In Mogadishu's Dharkenley District, SOS CV opened an Emergency Health Centre in Badbaado IDP Camp on 23rd July 2011. The camp is said to be one of the biggest IDP camp in Mogadishu which hosts nearly 30,000 Internally Displaced Persons (IDPs). The District authorities and camp committees have been supportive of the program which is vital for the families living in the camp. Services being offered at the health centre include maternal and reproductive health, child health, first aid and treatment of common illness, health/nutrition education and promotion. The centre also offers referral services to nearby Banadir Hospital as well as to the SOS main Mother and Child Hospital.

In Baidoa, SOS CV has been operational since July 2008 and was among the fewer organizations which were allowed to continue its humanitarian operations during the years Al-Shabaab was in full control of the town. SOS Medical Centre in Baidoa (also known SOS OPD/MCH Clinic) remains a unique medical center which provides emergency health services to women, children, young and elderly people. The medical Centre is located in the external section of Berdale quarter in Baidoa town, an area of which all the four quarters in Baidoa and surrounding IDPs have full access to the services offered. Despite the increasing difficulties and dangerous operating environment facing humanitarian actors in many parts of South Central Somalia, hurdles, and the suspension or closure of health projects, Baidoa Medical Centre continued to deliver in the most difficult locations in the country.

The basic health services provided allowed the groups living in the catchment area to benefit from quality healthcare. Due to women and children's higher vulnerability on the ongoing crises and emergencies, the programme focuses on meeting the need for maternal, reproductive and neonatal care services as well as child health for the target population. Male beneficiaries will have equal access to outpatient services, prevention and treatment of STIs, lifesaving support, Kala Azar treatment and laboratory/pharmaceutical services. Men are also fully involved in health/nutrition education and promotion, prevention of Gender Based Violence, discussion on maternal and child health promotion.

c) Timing of the evaluation

The evaluation will take place between the February 27^th, 2017 and March 15^th, 2017.

2. OBJECTIVES OF THE EVALUATION

2.1. Overall objective

The overall objective of this evaluation will be to determine the impact of the “Mother and Child Health Care” programme

2.2. Specific objectives

2.2.1Relevance

Assess design and focus of the project
• To what extent did the Project achieve its overall objectives?
• To what extent were the results (impacts, outcomes and outputs) achieved?
• Was the project relevant to the identified needs?

2.2.2Effectiveness

Describe the management processes and their appropriateness in supporting delivery

Was the project effective in delivering desired/planned results?

To what extent did the Project’s M&E mechanism contribute in meeting project results?

2.2.3Efficiency

Of Project Implementation
• Was the process of achieving results efficient?
• Were the resources effectively utilized?

• Did project activities overlap and duplicate other similar interventions (funded nationally and /or by other donors?

• What are the strengths, weaknesses, opportunities and threats of the project’s implementation process?

2.2.4To document the current figures of the Key Result Indicators as found in the log frame for the programme documents.

2.2.5Sustainability-

• To what extent are the benefits of the projects likely to be sustained after the completion of this project?

• How were capacities strengthened at the individual and organizational level (including contributing factors and constraints)?

• Describe key factors that will require attention in order to improve prospects of sustainability of Project outcomes and the potential for replication of the approach?

• Describe the main lessons that have emerged?

• What are the recommendations for similar support in future?

2.3. Desired results

The desired results of the evaluation are:

• To document the impact of the programme with special emphasis on the impact the programme has had on women and children.
• To provide commentary on the overall programme design, the intervention logic and an analysis of the strategy and methodology used in Mother and Child Health Care programme.
• To critically examine the log frame and verifiable indicators found in the original proposal and provide post-programme figures along with a narrative explaining the reasons for under/over performance achievement.
• To draw conclusions, make recommendations and state lessons learnt for future strategy and improvements in implementation of the programme.
• To provide commentary on the current political, social and cultural factors impacting the implementation of the programme.
• To document the communities’ attitude towards the programme

3. WORK PLAN

The evaluation will be carried out in 3 stages:

Stage 1:

Undertake a desk study analysing all documents regarding the operation, context, previous operations, and partners involved in the implementation of the programme. These documents will be presented to the consultant who will then use the information to plan for the field study. At this stage, preparations for the field evaluation exercise will be finalized: key informants will be identified, resources will be mobilised and a final version of terms of reference and timetable for the field visit will be confirmed.

Stage 2:

At this stage, the consultant will hold preliminary discussions and interviews with key informants amongst the programme implementers. The field work will consist of discussion to be held at field level with key SOS personnel, beneficiaries and partners and should encourage free and frank exchange of views about the implementation and effectiveness of the intervention. Following the evaluation, a one-day workshop should be convened to discuss observations and findings of the evaluation with all the key informants. During this time, key statistics will also be gathered from the adequate sources so as to provide figures for the Objectively Verifiable Indicators found in the log frame.

Stage 3:

This is the debriefing stage and submission of findings including recommendations and conclusions.

• The first draft report(s) should be submitted by electronic transmission in accordance with the report format given below for comments to SOS CV Somalia by March 11^th, 2017.
• The final draft will be submitted to SOS CV Somalia no later than March 15^th, 2017 and should incorporate the comments made by SOS CV Somalia staff based on the first draft of the report.

4. REPORT

4.1 The evaluation will result in the drawing up of “Mother and Child Health Care” programme evaluation report written in a straightforward manner, in English, of a maximum length of up to 18 pages including the Executive Summary, which should appear at the beginning of the report.

4.2 The report format appearing below must be strictly adhered to:

• Cover page

→ Title of the evaluation report:

→ Country, Programme Name

→ Date of the evaluation

→ Name of the consultant

• Table of contents

• Executive Summary:

A tightly drafted, succinct and freestanding Executive Summary is an essential component. It should be short, no more than two pages. It should focus on the key purpose or issues of the evaluation, outline the main points of the analysis, and clearly indicate the main conclusions, lessons learned and specific recommendations. Cross-references should be made to the corresponding page or paragraph numbers in the main text.

The structure of the Executive

Summary must be as follows:

→ Evaluated action

→ Date of the evaluation

→ Consultant’s name

→ Purpose & methodology

→ Main conclusions: These conclusions should refer to the main evaluation criteria and cross-cutting issues dealt with by the consultant and set out under the purpose of evaluation of the terms of reference.

→ Recommendations

→ Lessons learned

§ Main body of the report:

The main body of the report shall refer to the points listed under desired results. In-depth technical analysis of each intervention will be provided as an annex to the main report. It shall elaborate, although not necessarily in the same order or following the same structure, the elements included in the Executive Summary. It will include references to the methodology used for the evaluation and the context of the project. In particular, for each key conclusion there should be a corresponding recommendation. Recommendations should be as realistic, operational and pragmatic as possible; that is, they should take careful account of the circumstances currently prevailing in the context of the project, and of the resources available for implementation, both locally and internationally (16 pages maximum).

• Annexes

→ Terms of Reference;

→ List of persons interviewed and sites visited;

→ Map of the areas covered by the operations financed under the project

→ Abbreviations.

4.3 All confidential information shall be presented in a separate annex.

4.4. A bound hard copy of the report and an electronic copy of each report (flash disk having the report in Word format) including all annexes must be submitted together with the final reports' hard copies.

5. REQUIRED SKILLS FOR THE CONSULTANTS

5.1. The consultant should have the following qualifications, skills and experience:

• University degree in Master of Public Health, relevant Health Specialization, Social Science or equivalent qualification

• Extensive experience in conducting end of project evaluations and sampling methodologies

• Experience in community based development approaches/participatory methods.

• Excellent communication and reporting skills

• Team Leader experience.

• Computer literate with skills on data analysis software EPINFO, or SPSS.

• Good command of both written and spoken English.

• Familiarity with global technical issues in public health in post conflict situations.

5.2. The consultant will work in close co-ordination of the mission. He /She will have responsibility of the overall co-ordination of the mission, of the elaboration of the Executive summary report and of the final coherence of the report, both in terms of content and presentation.

5.3. The criteria that will be used for selection are as follows:

5.3.1 Method: The proposed method for evaluating the impact of the programme is suitable.

5.3.2 Timetable/work plan: The timetable/work plan are realistic and meet the needs of the programme

5.3.3 Cost: The cost of the proposal given the availability of data, analysis, method, and other aspects of the proposal are reasonable and feasible.

5.3.4 Experience: The level of training and experience of the consultants in undertaking impact evaluations and recommendations from organizations for which the consultant(s) have worked previously.

5.4. Proposals should include details on data use, indicators of impact, method, and strategy for institutional analysis, work plan, costs, and CV of the consultant.

Interviews will be conducted on the 24^th of February, 2017.

6. TIMETABLE

The evaluation will be conducted within fifteen days and final report should be submitted by March 15^th, 2017.

Interested consultants who meet the conditions specified herein are invited to submit their technical and financial proposals including proposed work plans, Curriculum Vitae of lead Consultant(s) and a clear demonstration of understanding and interpretation of this Terms of Reference (TOR) to: hr@sossomalia.org and indicate End of Project Evaluation ofMother and Child Health Care Programme in the subject line, to reach not later than 21^stFebruary, 2017.