Catholic Relief Services (CRS) is an International non-governmental organization supporting relief and development work in over 99 countries around the world. CRS programs assist persons on the basis of need, regardless of creed, ethnicity or nationality. CRS works through local church and non-church partners to implement its programs, therefore, strengthening and building the capacity of these partner organizations is fundamental to programs in every country in which CRS operates. CRS has been active in Ghana since 1958 and is currently implementing programs in the areas of Health and Agriculture/Livelihoods.

Job Description

TERMS OF REFERENCE
BASELINE STUDY FOR RURAL EMERGENCY HEALTH SERVICE AND TRANSPORT (REST) PROJECT

1.0 Introduction

Catholic Relief Services prides itself with over 50 years of dedicated service to the Ghanaian people. Since 1958, CRS has been working with the support of the Government and in partnership with the local Catholic Church to improve the quality of life among the poorest and most vulnerable populations.

The scope of CRS Ghana’s development assistance has varied over time with program activities in Education, Health, Agriculture, HIV and AIDS, Conflict Resolution, Microfinance and Water and Sanitation. CRS has reached millions of Ghanaians, particularly women and children with development assistance over the agency’s history in Ghana.

As part of mobilization of resources to strengthen its health and water, sanitation and hygiene (WASH) programming portfolio, CRS Ghana submitted a funding application to a US based Charitable Trust in September 2013.  The project, Rural Emergency Health Service and Transport (REST) was subsequently awarded in January 2013.

Following the award of the REST Project, CRS Ghana seeks the services of a consultant to conduct a baseline study for the project. The following Scope of Work (SOW) describes the role and responsibilities of the consultant.

2.0 Background of the Project

In Ghana, limited access to formal health care facilities remains a key bottleneck in the health care delivery system. Vulnerable, rural households experience the greatest challenges in attaining timely access to health care facilities during emergencies. The limitation of accessing medical care, especially during maternal and child health emergencies, is a major barrier in Ghana's effort to achieving the Millennium Development Goals 4 (reduce child mortality) and 5 (improve maternal health).

Maternal and neonatal deaths in Ghana, particularly in rural communities, are caused by a complex interaction of economic, financial, social, and cultural factors that affect service access and quality. There is reasonable access to antenatal care, with more than 96% of pregnant women 15-49 years receiving antenatal care from a skilled provider. However, institutional delivery (skilled care at childbirth) is lower (68%), despite the free maternal care policy that was introduced in 2003 (Ghana Statistical Service et al, 2012). An assessment suggested that though the policy led to increases in institutional deliveries, maternal mortality (451/100000) and under-5 mortality rates (82/1000)  still remain high (Ghana Statistical Service et al, 2012).  The persistent high level of maternal and child mortality revolves around the "three delays": 1) inability to recognize the problem and make a quick decision to seek care; 2) inability to reach the point of care; and, 3) delay in receiving appropriate and high-quality care.

To help address the issue of maternal and child mortality caused by the three delays, CRS and GHS propose the Rural Emergency Health Service and Transport (REST) Project.

3.0 The goal and strategic objectives of the project

The REST project seeks to improve the health and wellbeing of 850,000 vulnerable women of reproductive age and children under-five across six underserved districts of Northern (West and East Mamprusi as well as Mamprugu-Moaduri) and Upper East Regions (Talensi, Nabdam and Kasena Nankana West) by creating more access to quality health care from the nearest health facility.

Key outcomes of the REST project include the following:

•   Women (aged 15-49) and children under-five in the project districts have access to quality health care
•   Project communities have access to rural ambulances to facilitate transport of women and children to health facilities during emergencies
•   Health service providers have improve capacity and working tools to provide quality health care to clients

4.0 Scope of Work of the consultancy

The main objective of the consultancy is to establish a current community and health facility level base-line status on access, utilization and provision of maternal, new born and child health services in the REST Project districts, in relation to the regional and national situation. The findings will be consolidated to establish a comprehensive understanding on MNCH across the project districts. The base-line will determine bench-marks for target setting within each result area, as per indicators set out in the original results frame (output and outcome table); validate if the activities within the project design are sufficient in scale and scope, in order to meet these targets; and identify opportunities for sustainability of project activities.

The specific objectives of the base-line survey will be to:

•   Establish the prevailing health conditions, and health problems including diseases affecting mothers, infants and children under the age of five within each of the three targeted districts.
•   Determine current levels of knowledge, attitudes and practice towards MNCH issues and access to MNCH services in each of the targeted communities.
•   Determine the capacity of the district health systems (including public, private and community-based health systems) to provide MNCH services. This includes the availability and accessibility of health facilities and services offered for mothers, new born and children under the age of five, in terms of distances, cultural acceptability, affordability, availability and appropriateness (client-friendly, inclusive, responsive, hygienic)
•   Establish the key determinants of delays in accessing MNCH health services within the target communities
•   Assess the availability, administration and management of structures and systems in supporting MNCH emergency services within the target communities
•   Establish the capacity of communities, community structures and other stakeholders and partners to address MNCH and improve over-all health and nutritional status of targeted communities.
•   Establish the capacity and opportunities for institutionalization and sustainability of MNCH initiatives among the stakeholders and the target communities.
•   Based on these results, make recommendations for social behaviour change communication messages for use to advocate for support on the access and use of MNCH interventions at the community and health facility levels.

Main Tasks of the Consultancy

The consultant(s) will work in conjunction with the Catholic Relief Services’ Health Program Manager and the REST Project Coordinator, the REST M&E Specialist to finalize the design and inception plan for the study. Within REST project districts, the consultant will work with the Project’s Community Mobilization Specialist and the Field Officers, and local stakeholders to co-ordinate, conduct the study and disseminate the base-line findings. The consultant is expected to undertake the following tasks:

•   Carry out a desk-review of relevant project documents (to be provided upon signing the contract), including project proposal, results framework/output and outcomes table, budget and other relevant documents, a range of which will be agreed upon and made available prior to the implementation of the study
•   Develop an inception report, detailing the evaluation design, methodology, indicators, tools, work plan schedule and budget to carry out the assignment in the project districts. This will be developed and finalized in consultation with the REST team in Catholic Relief Services.
•   Develop a Sampling Design and Data Collection & Management Protocol that is standardized including key rapid catch indicators. The data collection tools should adequately address the gender (men and women) perspectives around MNCH
•   Facilitate training of field staff (supervisors, interviewers, observers/record reviewers) and pre-testing of data collection tools.
•   Co-ordinate collection of data, and its entry into a suitable platform for cleaning and analysis
•   Analyze and interpret the findings
•   Develop and submit the first draft of the base-line study report and debriefing to Catholic Relief Services, local partners and DHMTs. The reports should be comprehensive and provide detailed specific findings within each result area, providing key recommendations for implementation.
•   The lead consultant will be required to facilitate dissemination at a sitting with key project staff and partners and others to discuss the findings and develop an action plan based on the result of the baseline assessment.
•   Submit the final evaluation report to CRS .i.e. 6 Hard Copies and An electronic copy. The raw data, the data-base which has been cleaned (both qualitative and quantitative, including original field notes for in-depth interviews and focus group discussions, as well as recorded audio material), and data collection tools used in the evaluation should be submitted together with the report. A simple inventory of material handed over will be part of the record. CRS has sole ownership of all final data and any findings shall only be shared or reproduced with the permission of CRS.

The lead consultant will be expected to compile and submit the draft report, make a presentation to CRS, incorporate comments and submit a final report within 14 days of the end of the evaluation.

5.0 Deliverables

•   Inception Report detailing the evaluation design, methodology, tools, work plan and budget
•   Data collection tools, data set with codebook
•   Draft and final Base-line Survey Report.
•   Copies of original and cleaned data sets including field notes, audio tapes, and transcribed material

Please note that the contents of the report will be analyzed and final payment will only be made upon approval of the final Base-line Survey Report from the CRS.

The final report is expected to be organized as follows:
I. Executive Summary
II. Introduction
III. Study Description
IV. Methodology
V. Summary of key findings including key indicators and other prioritized indicators with numerators, denominators and confidence limits
VI. Conclusions and Recommendations for future directions
VII. Annexes:
a. data set
b. The Study Team Members
c. List of Interviewers
d. Methodology
e. Questionnaire, Guides/ tools
f. Terms of Reference

Please note that the contents of the report will be analyzed and final payment will only be made upon agreement on the final Baseline Survey Report from the CRS Country Program Team and the CRS Regional Technical Advisor for MCH.

6.0 Time-frame

The assignment is expected to commence starting May 28, 2014 and is expected to take a maximum of 30 days, which includes desk-review, preparation, and implementation, report-writing.

7.0 Role of CRS Ghana and collaborators

CRS Ghana will perform the following roles in the conduct of the baseline study:

•   Provide project documents such as the  project proposal, list of communities and schools
•   Form a Baseline Assessment Coordinating Team, which includes CRS staff, local authorities (DHMT, GHS staff, Local government agents as necessary) and other partners involved in the project
•   Facilitate ground preparation such as community entry processes, arrangements for interviewees to be interviewed
•   Review tools and provide support in the data collection process.
•   Facilitate the conduct of community entry processes in all the survey communities

The consultant will be responsible for guiding the entire evaluation process and all other specific responsibilities as stipulated in the SOW.

Qualification Required & Experience

8.0 Expected Profile of the Consultant

The lead consultant is expected to hold the following qualifications in order to be eligible for this position:

•   A recognized university degree in public health, international development, medical anthropology or related social science (at a minimum of Masters level)
•   Sound knowledge of major development issues, especially maternal, new born and child health issues. Knowledge of the context in Ghana is a requirement.
•   At least 5 years of consultancy experience in the area of public health and reproductive health/gender issues both in organisations and in projects
•   Experience in the formulation, monitoring and evaluation of projects in Maternal, New Born and Child Health/Public Health.
•   Similar work in the last 3 years (to provide copies of reports).
•   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.

Location: Accra

How To Apply For The Job

9.0 Response Proposal Specifications

Those interested in the consultancy must include in their application detailed technical and financial proposals with the following components:

•   Technical: Understanding and interpretation of the terms of reference, methodology to be used in undertaking the assignment and time and activity schedule
•   Personal: Consultant’s daily rate in Ghana cedis and availability between May 26 and June 30 2014
•   Organizational and Personnel Capacity Statement: Relevant experience related to the assignment, Appropriate references  and Curriculum Vitae

10. Submission of Proposals

The proposal can be sent by e?mailed so as to reach the undersigned by May 26, 2014 to:

Operations Manager
Catholic Relief Services
P.O. Box AN 6333
Accra Ghana

Tel: 0302-776188/776735   

Email: Kwasi.Attuahene-Mensah@crs.org

Closing Date: 26 May, 2014

11.0 Evaluation and Award of Consultancy

CRS will evaluate the proposals and award the assignment based on technical and financial feasibility. CRS reserves the right to accept or reject any proposal received without giving reasons. CRS will contact qualified applicants for an interview.