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Save the Children Research Partner Terms of Reference – Accelerating Reduction in Maternal and Newborn Mortality in Bungoma

Category: General Jobs in Kenya
Posted: Feb 20, 2014

Save the Children Research Partner Terms of Reference – Accelerating Reduction in Maternal and Newborn Mortality in Bungoma


Terms of Reference (ToR) for Research Partner

Position: Research Partner

Programme Title: Accelerating Reduction in Maternal and Newborn Mortality in Bungoma county, Kenya
Subject of Service Contract: Baseline Assessment and Ongoing Monitoring
Duration of Service Contract: February 2014 – January 2015
Location: Nairobi with frequent travel to Bungoma

Required: Institutions Only

Status: New

1. Background and Context

1.1. Save the Children Signature Programmes

Save the Children aims to accelerate our progress towards achieving dramatic change for children over the next four years. To increase the impact of our current approach, we are developing a number of signature programmes.

A signature programme is one which is designed to achieve breakthrough for children through the implementation of evidence based interventions that are replicable and scalable and that can generate positive results for children. These programmes will be used as beacons to attract more funding.

The success of the signature programme is measured by the adoption of the successful intervention and replication to scale by government and other agencies.
These programmes will demonstrate how Save the Children, in partnership with others, tackles issues that threaten children’s ability to survive, thrive and achieve their rights.
We are developing innovative ways to ensure we have maximum impact so that children can directly benefit from large, high quality programmes on the ground.
Critically, signature programmes will allow us to clearly demonstrate evidence of our successful impact, evidence that we will use to persuade others to replicate them on a mass scale, within a country and across continents.  We’ll also use this evidence to change the policies and practices of governments and other actors.

1.2. The Kenya Context

Every year, approximately 56,400 children will die during their first month in Kenya. Nearly 15,000 will die within 24 hours of their arrival in the world, while thousands more will not survive to see their first birthday. Newborn children are dying from conditions such as birth asphyxia and from infections such as neonatal sepsis and pneumonia. For Kenya’s mothers, the situation is similarly bleak.
Approximately, one in 200 mothers will die during childbirth {Kenya Demographic Health Survey (2008/09)}, placing Kenya a long way short of its target under Milennium Development Goal (MDG) 5 – to achieve a reduction in its maternal mortality rate to fewer than one maternal death in every 680 live births.
Progress towards the MDGs 4 and 5 has been slow as a result of limited availability, poor accessibility and low utilisation of skilled attendance during pregnancy, child birth and the postnatal period.
This lack of service utilisation combines with low coverage of basic and comprehensive emergency obstetric and newborn care, and poor involvement of communities in Maternal and Newborn Healthcare (MNH)  {Ministry of Health – “Community Midwifery Services in Kenya Implementation Guidelines”. Second Edition August 2012}.
More than half (52%) of Kenyans live over five kilometres from the nearest health facility or health worker and, for those living in remote districts and arid areas, the distances are often far greater.
Many deaths among mothers and children are therefore occuring at home, exacerbated by often unsanitary conditions, poverty, malnutrition and a lack of knowledge of, and proximity to, basic healthcare.

It is clear that without a significant acceleration it is unlikely that Kenya will achieve its targets for MDG 4 and 5 by 2015.

For this reason, Save the Children has planned an ambitious Signature Programme to support the government of Kenya in accelerating reduction in maternal and newborn mortality.
The design of the Kenya Signature Programme (KSP) began in July 2013, in Nairobi, through a broad consultative process that included Ministry of Health officials (Division of Reproductive Health and Division of Community Health Services), representatives of UN agencies (UNICEF, WHO and UNFPA), representatives of INGOs as well as the private sector.
After a detailed bottleneck analysis, that included equity – deprivation mapping, there was a unanimous consensus on the thematic focus – maternal and newborn health; and the potential geographic areas with the highest contribution to child deprivation according to a study conducted by UNICEF.
Other factors included presence and coverage of interventions by other agencies; potential impact in terms of number of lives saved and the existing presence of Save the Children in North-eastern province.
This process resulted in the selection of Bungoma and Wajir as the pilot counties.

The overall aim of this signature programme is apply a set of maternal and newborn proven (evidence based) interventions at scale so as to contribute to an accelerated reduction in maternal and newborn mortality in the targeted counties.

This will be achieved by technically addressing supply and demand side barriers to allow increased access to quality health care at community level linked to functional referral services.
We will also address the weak enabling environment through advocacy and mobilisation of the county government for clear child friendly budget allocation and increased investment in the provision of quality health services as well as promotion of broad public private investment partnerships towards this initiative.
The involvement and participation of the communities and their managerial processes, the community health committees, provides the voice and ownership.
The SP will at the same time address the immediate, underlying and structural causes of maternal and newborn mortality, applying best practices and innovative tools that would contribute to a sustained outcome

Implementation of the SP will follow a phased roll-out of the SP intervention package across project communities in each county, with a random 25% of communities implementing the SP package in four phases.

Given that simultaneous delivery of the SP across all sites would be infeasible, sequential roll-out of the SP allows for careful, manageable implementation while also creating an opportunity for a strong, stepped wedge evaluation design.

* Project communities = unit of analysis and randomisation; defined as distinct geographic areas comprised of PHC and affiliated CHWs, TBAs, and residents in surrounding 5km, where we expect impact of the SP

^Data about non-SP communities to be drawn from secondary data sources like DHS, HMIS, etc

The stepped wedge approach to implementation has been selected so that:

  • The effects of the SP can be measured and attributed to the SP by comparing key indicators among communities with the intervention package and those awaiting the intervention (‘SP-to-be’ communities serve as the comparison). This helps to answer questions about whether the SP works, i.e., achieves its objectives to improve the lives of women and children compared to non-SP sites.
  • Data collection can be timed to coincide with the implementation phases – to measure change before and after implementation at each phase – as well as a baseline survey (at T0) to capture status quo in all communities prior to any SP implementation (and control for any pre-existing differences observed among communities).
  • Capturing process indicators – to assess whether the intervention was implemented as intended – as well as outcome indicators will allow us to understand why the programme did or did not achieve its objectives (overall or by community), and how best to replicate the most successful cases.
  • This design allows us to make comparisons across communities at each time point, as well as within the same communities over time. The latter allows us to capture the effect of time on the effectiveness of the SP (e.g., can effects be sustained? Or do they ameliorate without sustained efforts?).
2. Purpose of the TOR 

The main purpose of the terms of reference will be to outline the scope of work to be covered by the successful applicant.

It will also outline the roles and responsibilities of each party, the expected deliverables and the payment schedule.
The ToR will also highlight the issues related to intellectual property rights.

3. Scope of Work

The successful applicant will be responsible for the planning, execution and quality control of baseline as well as ongoing monitoring of the signature programme.

The baseline will be expected to address the following questions:
  • What are the pre-intervention barriers to uptake of maternal and newborn health services at community level?
  • What is the availability and readiness of health facilities for the delivery of the high impact quality maternal and newborn interventions?
  • What is the current utilisation rate of maternal and newborn health services in the target facilities within the sub county?
  • What is the baseline policy environment (both county and national) in regards to MNH financing and human resources for health?
The programme monitoring should be able to provide information on:
  • Progress made against the programme targets as outlined in the log frame – this will also include recommendations for changes in strategy where necessary.
  • Gaps in data collection with recommendations given
  • Gaps in technical capacity of the SCI MEAL team with recommendations given
  • Analysis of the data base to provide external quality assurance, gaps and issues identified and recommendations for further improvement.
  • Strengths, weaknesses, opportunities and threats of the programme’s implementation process
For the first quarter of 2014, the contractee will be expected to input into the design of the signature programme database and data collection tools.

4. Methodology 

The contractee will propose methodology, tools, and workplan for the baseline and for the on-going monitoring of the programme.
The contractee will also provide a capacity statement showing their previous experience in carrying out this type of work in the same or a similar context.

4.1. Reference material

4.1.1. Programme proposal
4.1.2. Programme log frame
4.1.3. Child Safeguarding policy

5. Time Frames 

The time frame for the activities will be as follows:
  • Baseline survey – this will be conducted from April to June 2014
  • Ongoing programme monitoring – this will be conducted on a quarterly basis at the following intervals; July 2014,  October 2014, January 2015
6. Expected Deliverables
6.1. Project baseline. 
This will be comprised of:
6.1.1. A baseline protocol with ERB approval. 
The baseline protocol should provide a detailed methodology outlining how the contractee will answer the following questions:
The contractee will also be expected to obtain the relevant ethical review and approval. Field work will only commence once this protocol has been reviewed and approved by the SC review board.
6.1.2. Data collection tools and templates
The contractee will be expected to develop the relevant data collection tools and templates.
These will be shared with SCI for review and approval in accordance with the agreed-upon timeline
6.1.3. Baseline survey report including findings and recommendations for programme design as well as the raw data set 
The draft survey report must be submitted to the SC designated contact person within 10 working days after completion of field work and data analysis.
The final report of the survey, after integration of the various comments made, must be submitted within 5 working days after reception of the comments from SC.
6.1.4. Project log frame with baseline section completed
As part of the draft survey baseline report, the contractee must submit the project log frame with the baseline column completed.
This should also be submitted within 10 working days after completion of field work
6.1.5. Validation workshop
The contractee will be expected to hold a validation workshop where they will present the methodology, challenges faced, key findings under each of the survey criteria and main recommendations.
The participants of the workshop and the venue will be agreed upon between SCI and the contractee.
6.1.6. Final report
The final report should be submitted within 5 working days after the validation workshop.
This will be submitted in soft copy by email and 5copies on CD/Flash disk
6.2. Ongoing programme monitoring
The contractee will also be expected to prepare a detailed schedule for the quarterly programme monitoring shwing how they will address the question in section 3 above

7. Administrative / Logistical Support 

7.1. Budget and work plan
The contractee should submit to Save the Children forecast of the budget which should include all transport and accommodation costs in the field.
This should also include communication costs while in the field.
The budget should be prepared in the format that has been provided as an annex.
The budget should be accompanied by a work plan for the duration of the contract.

7.2. Schedule of payment 

The following payments will be made to the consultant using and agreed mode of payment.
The payment for the 2 deliverables will be made independent of each other
7.2.1. Baseline
  • 40% of the baseline budget will be paid upon signing of the contract.
  • 60% of the baseline budget will be paid upon delivery of the final report
7.2.2. Programme monitoring
  • 40% of the payment for ongoing programme monitoring will be made at the beginning of each quarter
  • 60% of the payment for ongoing programme monitoring will be made after submission of the previous quarter’s monitoring report
7.3. Taxation
5% withholding tax will be retained as part of the payment and remitted directly to the Kenya Revenue Authority.
The contractee should ensure that their budget includes this figure.

8. Desired competencies of the successful contractee (only institutions should apply, STRICTLY NO INDIVIDUALS)

  • At least 15 years’ experience in Kenya conducting research defining and assessing quality of reproductive health (RH) services using the health facility assessment (HFA) methodology; strengthening health systems in developing countries, and in developing quality assurance tools including quality accreditation systems.
  • Experience in  research on community based interventions is a plus
  • Proven experience in conducting policy research and analysis
  • Proven experience publishing in reputable journals. Evidence of this should be provided with the application
  • Demonstrated ability to conduct complex programme evaluations
  • Proven experience in working as as the monitoring & evaluation partner for service delivery programs
  • A demonstrated high level of professionalism and an ability to work independently and in high-pressure situations under tight deadlines.
  • Strong interpersonal and communication skills
  • High proficiency in written and spoken English
  • Understanding of child safeguarding and child participation procedures
How to Apply

The application process is now open and will close on 28th February 2014.

To apply for this position, please fill the attached EoI and send to [email protected] and cc. [email protected] indicating the Assignment title on the subject line.
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