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Consultant - Evaluation of the Multi-Sectoral Public Health Intervention

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Andrew Miller


Normal user

5 Oct 2017, 17:20

Country programme South Sudan
Total time frame October 2017 – January 2018
Reports in the field to Medical Advisor, Nutrition Advisor, WASH Advisor, M&E Manager
Reports at HQ to HQ Monitoring & Evaluation Advisor, HQ Health & Nutrition Advisor, and Senior WASH Advisor
Final report deadline 15th January 2018

TITLE: Consultant - Evaluation of the Multi-Sectoral Public Health Intervention in Batil Camp

After fighting began in Blue Nile State (Sudan) in September 2011, people began fleeing across the border into Maban County (former Upper Nile State, South Sudan). By July 2012, over 105,000 refugees had been registered and were situated in four large camps established by UNHCR in collaboration with the local authorities. Batil camp was opened in May 2012, but grew from a few thousand to 35,000 refugees in the space of a month.
Medair’s ERT (emergency response team) began a joint WASH and Health response in Batil camp in August 2012. The response was initially expected to be relatively limited in scope and timeframe, since there were already a number of other WASH and Health actors in the camp. However in 2013, as other NGOs began to leave Maban, Medair’s programme expanded significantly. By June 2014 Medair was responsible for all WASH, health and nutrition services in Batil camp, serving approximately 40,000 people.
The strategic aim of the Maban project was to develop, implement, and adjust as needed high quality services that address emergency needs in a demand driven and responsive manner. The overall goal of all Medair programme is to relieve human suffering in the most remote and devastating places by bringing relief and recovery to the people in crises without considering their creed, race and religion. This project has been designed to fit into the strategy especially the component of saving lives through improved integrated primary health care programme. The project has been implemented for the last 5 years and will be coming to an end on December 31st 2017. Therefore, this ToR has been prepared to hire highly competent external consultants to evaluate the performance of this project for the implementation period. The evaluation of this project will help the key stakeholders to measure the level of project impact and the extent to which objectives were achieved with reference to service delivery to the project beneficiaries.

The main purpose of carrying out an external evaluation of the project just before exiting Maban is to assess the impact, appropriateness, relevance, effectiveness and sustainability of this multi-sectoral public health intervention, and this should help to draw and document key lessons learnt and the best practices to the project stakeholders and Medair. In addition to the general multi-sectoral end-of-project evaluation that will cover all three sectors (health, nutrition and WASH), a more in-depth technical evaluation of the WASH component shall be conducted simultaneously. It is intended to contract a separate WASH consultant to provide a technical evaluation of the WASH intervention because (a) this requires experience and knowledge that a general public health consultant is unlikely to have, and (b) due to the scale, complexity and challenges in the WASH intervention Medair would like to evaluate this in more depth so that lessons learnt can be used by both Medair and other WASH actors to adapt and improve similar responses in future.
Both evaluations mean to identify any gaps, and provide recommendations on what could be improved in future similar interventions. It is intended that the final reports will also be used internally to guide Medair’s planning and preparation for future interventions.

1) Impact
Assess the wider effects of the project –social, economic, technical, environmental on individuals, gender- and age-groups, refugee and host communities and institutions.
- What are the positive and negative impacts, including on morbidity and mortality?
- Do positive effects outweigh negative impacts?
- Were there unintended negative impacts
- Were there unintended positive impacts
- Did the project have an added value?
- Where could the project have had more value? Was Medair investing in national staff members, refugee staff and community members in the course of trainings, on the job capacity building and long-term employment?
- Are the beneficiaries and host community knowledgeable and supportive to the project? Has there been any collaborations and networking with the different stakeholders? Is there evidence of community contribution and ownership of the different project interventions?
- Did Medair ensure gender-sensitive programming, e.g. involvement and empowering women in the planning, design and implementation of the programme?
- In which way did Medair’s WASH, health and nutrition programming have an impact on the environment?

2) Effectiveness
Assess the scope and timeliness of achievements of the project against the set objectives.
- To what extent have the results been achieved?
- What other activities could Medair have included to better achieve the results?
- The achievements against set objectives compared with planned outputs and how the outputs have been translated into outcomes. The evaluation shall also establish the possible deviation from planned outputs and likely outcomes.

3) Efficiency
Assess adequacy and efficiency of planning, monitoring and reporting systems, and use of both material and financial resources.
- To what degree has humanitarian aid been delivered as agreed?
- Could it have been done better, more cheaply and/or more quickly without compromising outputs?
- How adequate were the available resources qualitatively and quantitatively?

4) Coverage
Assess the reach of major population groups facing life-threatening suffering and the coverage of the projects.
- Has the project left out any groups?
- Have needs of all groups (women, children and men, disabled and other vulnerable groups) been addressed?
- How equitably has the project benefited women, men, boys and girls? Disaggregated benefits of the project by gender.

5) Coherence
Assess the consideration of security, developmental, trade and military policies and their consistency with humanitarian and human-rights considerations
- How did the project link with Medair’s other projects?
- Did Medair consider and address conflict sensitivity in the project design and implementation?

6) Connectedness
Determine whether activities of a short-term emergency nature were carried out in a context that takes longer-term and interconnected problems into account.
- Has the project addressed the needs of the population in the villages of origin (host communities living around the camps) and of the population living in the camp?
- How has the project impacted the surrounding host community and the existing health system?
- How was the programme integrated with other sectors, for example protection, education, camp management and livelihoods?

7) Relevance / Appropriateness
Assess relevance and appropriateness of project design in respect to the needs of the beneficiaries and host community.
- Community involvement and participation in the design process, goal setting, planning and implementation. In particular, the relevance and appropriateness of project design to the needs of the beneficiaries and host community.
- Did Medair have the right capacity to implement this project?
- Have the activities been appropriate in this project?
- Has the strategy been appropriate?

8) Sustainability
Asses the overall management and structure of the project.
- Are there sustainability plans, structures and skills in place to ensure there is sustainability of project benefits? How adequate are they? How are the beneficiaries and local partners prepared to continue with the project outcome?

9) Identify
Identify the strengths, areas of growth and challenges of the project.
- How did these affect the project implementation and how were they handled? Identify opportunities for the project if any and how they were exploited/ neglected?

10) Recommendation
Provide specific and practical recommendations and document lessons to be utilized for future projects.
- What best practices that have been adopted and how can they be replicated in future Medair projects, and what aspects should be avoided or improved in future projects?

This is an End of Project Evaluation that will assess the progress made by the project towards achieving the project goal of reducing morbidity and mortality of 42,943 people through integrated health, nutrition and WASH interventions in Batil camp, Maban. The assessment of the project impact will focus on the contribution made by the project from inception.
In addition to the general, multisectoral evaluation a WASH specific technical evaluation will be included in the evaluation report. For the technical WASH evaluation a technical report will be written which addresses all of the aspects listed above, with supporting data and evidence where appropriate. Both evaluations will be combined in one report. Each consultant will deliver one report which can be combined as part A) Multisectoral Public Health Evaluation that covers Medair’s health, nutrition and WASH intervention and part B) Technical WASH evaluation as per ToR. The report will contain a joint summary of both evaluations.
A draft report should be submitted to Medair by 12th December 2017. Medair will provide feedback on this report by 21st December, so that the Consultant can finalise the report by the 05th January 2018.

Prior travelling to South Sudan: Data review
Gathering information and review key documents such as needs assessment reports, donor proposals, logical frameworks, baseline report, monthly, quarterly, semi-annual and annual reports, training reports, success stories, clinic data, WASH (weekly) monitoring data, results from Knowledge, Practice Coverage (KPC) surveys and KPC reports, UNHCR SENS surveys and any district level secondary data and other relevant documents.

In Country: Data collection
Collect data on relevant topics in order to receive quantitative and/ or qualitative information on Medair’s impact in Yusuf Batil Camp, and conducting interviews with other relevant stakeholders in Maban. It is expected that both consultants work closely together in order to avoid duplication of data collection and reporting. The activities on data collection should be planned by both consultants in liaison.
Note, that in Maban, the Medair team (along with most NGOs, UNHCR and the Government authorities) are based in Bunj town, which has an airstrip nearby. The base has good internet access and HF/ VHF/ Thuraya communication – mobile phone coverage is intermittent. The team travel each day into Batil camp in a Medair vehicle, which is approximately a 20 minute drive.

At the end of data review and collection
The Consultant will be expected to deliver the following outputs at the end of data review and collection:
• Handing in of one report that contains one chapter of the multisectoral public health evaluation looks at Medair’s health, nutrition and WASH interventions and a separate chapter on the technical WASH evaluation. The report will contain a joint summary of both evaluations.
• An inception report detailing methodologies to be used and sample size calculations, a detailed execution plan, data-collection tools such as datasets provided in SPSS format with a full and complete data dictionary
• Data should be submitted to Medair for validation before narrative report is completed
• The consultants should also submit data analysis SPSS syntaxes as the syntax file will be relevant for the validation process
• Draft report submitted to Medair within an agreed timeline.
• A presentation of the key findings and recommendations to Medair Country Director and Sector Advisors in Juba.
• Collected data (raw) after analysis submitted to Medair alongside the final report. The final report will include the public health evaluation and the technical WASH report, so that an overall picture is given.
• Final report (soft and hard copy) submitted and presented to Medair, not less than 20 pages and not exceeding 40 pages using font size 11. The format of the report can be discussed after the results were presented.

The Evaluations should cover all aspects of the multi-sectoral public health intervention, including cross-cutting themes. Achievements should be measured against UNHCR, Sphere standards and best practice, and also consider whether the response represents value-for-money (though an economic analysis of the programme is not required).
The Evaluations should also look, not only at the current situation in the camp now, but as far as is practical also the historical development of the programme over the past five years. In particular, considering the speed of the initial emergency response and scale-up, the response to the Hepatitis E outbreak in 2012/13, impact on morbidity and mortality and key practices from periodic surveys through the years, and how technical designs and community engagement have evolved during the programme.

It is expected that the Consultants will gather data and information from a wide range of sources in order to ensure a comprehensive overview of the programme, including:
• Reference documents provided by the Medair Maban team. A significant amount of data has been documented by the team and can be shared with the Consultants including all surveys from 2012-2017 conducted in Batil camp by Medair and others, final donor reports and other key programme data.
• Field visit in Batil camp, supported by the Medair team
• Feedback from Medair Maban staff
• Interviews with other partners in Maban, including UNHCR, DRC (camp managers), LWF (education), Samaritan’s Purse (secondary healthcare & nutrition) and Relief International (health, nutrition and livelihoods). Visits to another camp and meetings with ACTED (the WASH agency in the other three refugee camps) for comparison
• Visits to another camp and meetings with other NGOs for comparison
• Interviews with beneficiaries, including camp leaders, women, refugee staff


Date Activity Number of days public health evaluation (multi-sectoral) Location
By 9.11
Medair has sent the consultants relevant background data and reports
13.11- 14.11. Review of the sent information. 2
15.11- Draft of the planned data collection methods for the time in Maban and share this with the field advisors, Maban project Managers and M&E Manager. 1
20.11.-21.11 Travel to Juba
Alien registration and security briefings. Time for additional information gathering from Medair staff that support the Maban team 1 Juba
22.11. Travel to Maban and security briefings 1
23.11- 06.12. Data collection in Maban 12 Maban
05.12. Data cleaning and analysis 1 Maban
06.12. Travel back to Juba 1
07.12. Presentation of the key findings to the Medair Country Director and Sector Advisors in Juba. 1 Juba
08.12. Travel back to home destination 1
11.12- 12.12. Draft report for review and comments. Submission of the first draft report on 12.12. to Medair. Both reports will be delivered combined in one format as described above. The report will have a joint summary at the beginning.
13.12.-29.12. Review of the first draft report by the field advisors. Drafting of comments and feedback which will be send to the two consultants by 29.12.2017
30. 12 Incorporation of comments 1
05.01. Final report submission 1

All reasonable steps will be taken to provide safety and security for the consultant; both Medair and consultant accept the inherent risks in working in humanitarian contexts. Medair will not be required to do more than what is reasonable and possible in the circumstances whilst providing a safe and appropriate work environment.

• International flights and accommodation in transit will be arranged by Medair via pre-selected travel agents and will, therefore, be paid directly by Medair.
• The consultancy fees payable to the consultant will be a negotiated lump sum based on experience and credentials. The fees are taxable in South Sudan and Medair will withhold that tax.
• This is calculated on the basis of an estimated 25 days of work. 50% of the consultancy fee (after withholding tax) will be paid into a bank account designated by the consultant at the completion of the field work.
• The remaining amount will be paid when the final version of the report has been finalized and approved by Medair. Full payment is dependent on the timely completion of the final report as per the agreed timeline.
• Any visa costs, cost of travel in country of abode, and meals while in transit (up to 3 meals per day, maximum 20 USD per meal, no alcohol, no snacks/drinks between meals) will be reimbursed into the designated bank account against receipt.

• All travel arrangements to and from the airport of departure in country of abode (reasonable travel costs to and from the airport will be reimbursable by Medair; reasonable means public transport, second-class travel and taxis only if no other options or if late at night).
• To arrange the required visas for travel to South Sudan, including visas of transiting countries if required (visa costs will be reimbursable by Medair).
• Fulfil the above outputs as listed within the timeframe stated.
• Obtain the necessary vaccinations before the start of the consultancy (not reimbursable by Medair).
• Comply with Medair’s security plan and recommendations on dress and behaviour, as given to expat staff.
• Provide laptop, software, or any other relevant equipment for personal use and report writing (not chargeable to or reimbursable by Medair).

• Arrangement of flights to and from Juba and booking of accommodation while the consultant is in transit if required.
• Provide transport within South Sudan.
• Arrange and cover the costs of in-country work permits and authorizations.
• Provide food and accommodation in South Sudan.
• Provide translators for consultant as needed.
• Provide staff for data-collection if required.
• Provide staff for focus group discussions and other activities, if required.
• Provide working facilities which will be as secure as is practical in the circumstances.
• Reimburse reasonable expenses with valid receipts.

Medair contracts for the provision of debriefing after any critical incident or assignment as needed

• Interested applicants should submit their applications including the below documents:
o Cover letter: A short (maximum one page) letter addressing the evaluation criteria
o Technical Proposal: A (maximum 4 pages) technical proposal highlighting: brief explanation about previous experience; understanding of the TOR, description of the stipulated evaluation and the tasks to be accomplished Curriculum Vitae: Detailed CV should be annexed and should indicate 3 professional references
o Financial Proposal: The financial proposal should provide cost estimates for services rendered including daily consultancy fees
Applications should be sent to: Only shortlisted candidates will be contacted.

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