2679079- Third-Party Monitoring - WASH and Health Support to Communities Affected by Displacement (SCAD) in Syria - MENA Jobs For Worldwide Job Vacancies

Except as acknowledged by the references in this paper to other authors and publications, the contents described in this Terms of Reference consist of our own work, undertaken to secure funding, implement the activities, describe and advance learning as part of the requirements of World Vision International Monitoring, Evaluation, Accountability and Learning System.

Primary quantitative and qualitative data collected throughout the Third Party Monitoring process remains the property of the communities and families described in this document. Information and data must be used only with their consent.

INTRODUCTION

This Terms of Reference (TOR) describes the plans, objectives, deliverables, and expectations for an external consultant to provide services for the Third Party Monitoring (TPM) for WASH and Health Support to Communities Affected by Displacement (SCAD) in Syria in Idleb and Aleppo governorates in North-west and Al Raqqa and Al Hasakeh Governorates in North-central Syria.

Background Information

Project Background

Goal:

To support crisis-affected displaced and host community populations in reducing the risk of disease and meeting basic WASH needs, World Vision (WV) and our partners propose a two-sector WASH and Health emergency response program in Northwest (NWS) and Northcentral (NCS) Syria. This goal aligns with BHA’s mission of saving lives, reducing poverty, helping people emerge from humanitarian crises and progress beyond assistance.

Theory of Change Statement:

If target households and communities are provided with improved water availability and quality, and if communities are supported by epidemiological surveillance through an early warning, alert, and response network, then target program participants will have their most pressing WASH needs met, and transmission of disease will decrease, and then mortality and morbidity resulting from water-borne disease and COVID-19 will be reduced.

Purpose1: Improve the health outcomes of targeted IDP and host community populations.

• BHA Sector Name: Health

Strengthening health systems to detect epidemiological trends and potential outbreaks of COVID-19 through an early warning, alert and response network.

• BHA Sector Name: Water, Sanitation, and Hygiene

Providing timely, sustainable, and equitable access to safe WASH services and health interventions to end the cycle of diarrheal diseases, and control health outbreaks.

Project Overview:

Number of People Affected in the Target Areas:

4,100,000

Number of People Targeted by Sex (e.g., 2,600 women, 2,400 men);

Total: 294,949 (150,448 men, 144,501 women)

Of the above total, number of IDPs Targeted

137,534

Of the above total, number of Refugees Targeted:

Geographic Areas:

NWS: Idleb, Aleppo, Hamah, and Latakia Governorates.

NCS: Al Raqqa and Al Hasakeh Governorates

Detailed Health Sector Descriptions

Sector Name:

Health

Applicant’s Purpose:

Improve the health outcomes of the targeted IDP and host community populations

Number of People Targeted by Sex (e.g., 2,600 women, 2,400 men);

Total: 126,720 (69,696 men, 57,024 women)

Of the above total, number of IDPs Targeted

44,352

Of the above total, number of Refugees Targeted:

Geographic Areas:

Regions

North West Syria, North Central Syria

Governorates

Aleppo, Idleb, Hamah, Latakia, Al Raqqa, Al Hasakeh

Sub-Sector Name:

Health Systems Support

Activity 1.1.1: Conduct active surveillance for COVID-19. World Vision through its implementing partner will respond to alerts of suspected cases of COVID-19 based on the WHO approved case definition at the designated 41 health facilities, 13 isolation centers, and six COVID-19 hospitals within the COVID-19 EWARN network. Conduct active surveillance, whereby the surveillance team searches for suspected cases in health centers that are likely to receive such cases, in order to increase the sensitivity of detection of COVID-19 cases and not miss unreported cases. The implementing partner will visit 25 health facilities on a weekly basis to monitor awareness among health care workers of the COVID-19 situation and their adherence to testing best practices. In addition, ACU will also collect samples on a daily basis from 60 health service providers as and when they raise alerts and deliver them to the logistics team for transportation to the laboratories.
Activity 1.1.2: Conduct contact tracing of potential contacts.

If a cluster of cases is identified, ACU will send a RRT to conduct contact tracing within the affected community, with a particular focus on those displaying symptoms who might not have come to the health service providers for testing. The first step of contact tracing will be to identify the contacts of the infected individual, in line with WHO’s definition of ‘contact’. A contact is defined as anyone with the following exposures to a COVID-19 case, from 2 days before to 14 days after the case’s onset of illness:

Being within 1 meter of a COVID-19 case for >15 minutes.
Direct physical contact with a COVID-19 case.
Providing direct care for patients with COVID-19 disease without using proper PPE.

Activity 1.1.3: Provide logistical support for COVID-19 surveillance and testing

ACU will also provide logistical support to provide the link between COVID-19 surveillance and testing. The 60 health service providers within the COVID-19 EWARN network will raise an alert with ACU when they have a potential case that they’ve tested. Accordingly, ACU’s logistics team will go to the respective health service provider to collect the sample(s) as part of their daily sample collection and will provide subsequent transportation to one of the four laboratories for analysis. In order to provide this service, ACU’s logistics team will be comprised of eight cars, all of which will be equipped with medical cold chain coolers to ensure samples are kept within the necessary temperate range to facilitate early detection of COVID-19

Activity 1.1.4: Support laboratories for testing of samples

ACU will continue support of three laboratories in NWS, specifically Idleb, Afrin and Jarablus, and scale up support to a fourth laboratory in NCS, specifically Tell Abiad, with operational costs and staff salaries. The laboratories will receive the samples delivered by ACU’s logistics teams and will conduct PCR testing in order to determine the presence of COVID-19.

The laboratories will aim to deliver results within 96 hours of the samples being collected by ACU. Results will be shared with ACU, who in turn will share the results with the person tested directly via WhatsApp. ACU will also share the results with the health care provider where the sample was taken

Activity 1.1.5: Provide epidemiological information to guide and further strengthen the preparedness and response measures

The second pillar of the COVID-19 Task Force includes reporting, and since 2020 ACU has been using the WHO Go-Data Platform as part of COVID-19 EWARN. The COVID-19 EWARN system provides reporting on a daily basis including zero reporting (i.e., no cases for the day) to WHO and partners to strengthen preparedness and response measures. The data is collected from all administrative levels in NWS and NCS and is shared daily in situation reports with all stakeholders and partners. A daily list is also provided to health facilities and camps and WHO. The daily bulletin provides a snapshot of key details within the previous 24 hours, including new cases, total confirmed cases, new tests undertaken, total tests undertaken, new recovery cases, total recovery cases, total active cases, new deaths related to COVID-19 and total deaths related to COVID-19. A more in-depth report is compiled weekly and this includes analysis of age, sex, geography, testing patterns and severity. This report is shared with key stakeholders and is available on the EWARN website. All reports are available in English and Arabic.

Detailed WASH Sector Description:

Sector Name:

Water, Sanitation, and Hygiene (WASH)

Applicant’s Purpose:

Through providing timely, sustainable, and equitable access to safe WASH services, and through pairing WASH programming with Health interventions, WASH sector activities aim to end the cycle of diarrheal diseases and control health outbreaks.

Number of People Targeted by Sex (e.g., 2,600 women, 2,400 men);

Total: 168,229 (80,752 men, 87,477 women)

IYD: 62,090 (29,805 men, 32,285 women)

WV: 80,000 (38,400 men, 41,600 women)

AFH: 26,139 (12,547 men, 13,592 women)

Of the above total, number of IDPs Targeted

Total: 93,182

IYD: 27,940

WV: 64,000

AFH: 1242

Of the above total, number of Refugees Targeted:

Geographic Areas:

Region

North West Syria, North Central Syria

Governorate(s)

Aleppo, Idleb, Al Raqqa, Al Hasakeh

Sub-district(s)

Ras Al Ain, Ein Issa, Suluk, Tell Abiad, Idleb, Dana, Azaz

Sub-Sector Name:

Sanitation

Activity List

Activity 2.1.1: Desludge septic tanks in 3 IDP camps in Azaz sub-district

A desludging local contractor will be hired by WV and partners to cover the desludging needs in three of the six targeted IDP camps in Azaz, namely Al Rayan, Talil Elsham and Al Zeytoun (with a combined population of 8,539 individuals). Based on the understanding of the needs on the ground, 83 desludging trips are expected on a monthly basis, with approximately 4.5m3 capacity for each truck. In total, 372m3 of wastewater will be discharged from septic tanks per month. Project supervisors will continuously be monitoring septic tanks’ levels and oversee desludging activities. In order to minimize the environmental and health impacts of the transported sludge, WV will make sure that all transported wastewater is offloaded into the nearest regular sewer system with the consent of the Local Council.

Activity 2.1.2: Provide operations and maintenance support to the wastewater treatment plant in Sujo camp in Azaz sub-district.

WV proposes to continue to provide operational and maintenance support to the Sujo wastewater treatment plant in Azaz. The Sujo wastewater treatment unit uses a Sequence Batch Reactor (SBR) approach. The unit was installed in 2018 using WV private funding and currently receives 450m3 of wastewater on a daily basis. The unit serves 11,399 individuals living in Sujo camp, Azaz sub-district. The concentration of organic matter in the influent averages 297 mg/liter and the concentration of the effluent averages 27 mg/liter. The efficiency of the treatment is approximately 90%.

WV will continue to provide fuel to operate the generators that pump the water to the treatment unit, and for aeration blowers at the bottom of the tanks. Pipes, valves, pumps, changing oil, filters for generators and desludging the sedimentation tanks all need regular maintenance. There is a laboratory inside the unit to monitor the Biological Oxygen Demand (BOD) and check the concentration of organic materials for both influent and effluent. Influent wastewater passes through filter screens for the removal of grit and large particulates before the SBR. The wastewater then enters a partially filled reactor, containing biomass, which is acclimated to the wastewater constituents during preceding cycles. Once the reactor is full, it behaves like a conventional activated sludge system, but without a continuous influent or effluent flow. The aeration and mixing stops after the biological reactions are complete, the biomass settles, and the treated supernatant is removed. After the SBR, the “batch” of wastewater may flow to an equalization basin where the wastewater flow rate to additional unit processed can be controlled at a determined rate. In some cases, the wastewater is filtered to remove additional solids and then be disinfected.

Effluent is disposed of in the sewer and the daily monitoring of organic matter is recorded. Local farmers sometimes use the effluent to irrigate their crops, such as corn feed for their animals. WV confirms that this wastewater meets the effluent water quality standards. Results from testing show that the wastewater is mainly between BOD 15 – 40mg/L, and as per the Syria standards, water must be effluent with BOD less than 100mg/L to be used for animal feed irrigation purposes. With these results well below 100mg/L, WV believes this effluent water can be used for animal feed and forest trees irrigation. However, it is to be noted that WV is not directly promoting using the effluent water for irrigation purposes, especially for edible crops. In fact, WV will continue to raise awareness and coordinate with local councils to discourage the use of effluent for crops/vegetables.

Activity 2.1.3: Rehabilitation of existing sanitation systems and sewage lines in 6 IDP camps (as needed) in Azaz sub-district and rehabilitation and expansion of sewerage system in Ras Al-Ain district

Existing sanitation systems and sewage lines in IDP camps are at risk of disrepair, damage, and neglect. Potential causes of damage include blockage with solid items, or breakage from traffic passing overhead, nearby construction or people connecting their home sewage line improperly. Potential causes of neglect or disrepair are due to lack of clear responsibility by municipal authorities combined with lack of financial resources. Without proper maintenance and repair it is likely that IDP populations resort to wastewater soak pits instead, which require frequent and costly desludging. Accordingly, to avert this potential trend and capitalize upon past investments in sanitation systems and sewage lines within six IDP camps, WV will conduct minor rehabilitation as needed. All rehabilitation work will be done as per the national technical standards for sewage network construction. The project will also include cleaning and rehabilitation of rainwater drainage systems to contribute to the winter preparation efforts to reduce the impact of regular floods.

AFH will prioritize aged pipes which experience sewage leakages and sections of overflow in Ras al-Ain district. The sewerage system is urgently in need of rehabilitation and expansion. AFH is also proposing interventions in neighborhoods not yet connected to the main sewage network to expand new lines to address the sanitation problem in the location through contracted work and designs according to local municipality. The diameter of these sewer lines will be selected according to existing pipes, population size and the estimated slope and flow of wastewater produced per person.

Sub-Sector Name:

Hygiene Promotion

Activity 2.2.1: Conduct hygiene promotion (HP) through integrated health and hygiene messages at the household level, and use World Vision’s ‘WASH UP!’ curriculum in 3 HP community centers constructed with prior USAID funding within the 6 targeted IDP camps in Azaz sub-district

Hygiene promoters will be hired and trained to deliver integrated hygiene promotion (HP), COVID-19 RCCE, and protection messages to 28,700 participants within the six targeted IDP camps. Participants will receive direct hygiene promotion at the household level through awareness campaigns including door-to-door visits, the distribution of IEC materials and FGDs in HP community centers. In addition, nudges and cues will serve as reminder to conduct healthy behaviors around WASH subject matter, such as posters in streets, on water tanks and solid waste vehicles, and social media etc., with tailored messaging to the appropriate setting and age groups.

As part of efforts to ensure hygiene promotion is gender and age-sensitive, WV will also conduct its Sesame Workshop WASH UP! Initiative. The Initiative educates children (aged 6-12) to live healthy lives, through promotion of behavioral changes in sanitation and hygiene using a 12-session play-based learning materials, and multimedia content program. During sessions, Sesame Street character-filled storybooks, games, videos, and teacher training materials are used to make healthy habits easy to understand, practice, and adopt. WASH UP! activities will be conducted at three existing WV HP community centers. The multi-country curriculum was developed with the support of the Bill and Melinda Gates Foundation and is contextualized through WV implementation in 14 countries. As part of a study of the program, Stanford University Health Department found that first graders demonstrated a 54% increase in knowledge of germs and a 39% increase in identifying unsafe sources of drinking water, demonstrating its success.

Sub-Sector Name:

Environmental Health

Activity List

Activity 2.3.1: Conduct solid waste collection and disposal

As solid waste can be another risk factor for environmental health, vector control and COVID-19 transmission through the indirect route (touching contaminated surfaces), WV and AFH will ensure solid waste in targeted camps and communities are properly collected and transported to official landfills with consultation with the responsible local council. Dealing with solid waste in landfills will be also discussed with the local council and will be burned or buried accordingly. A local contractor will be hired who will be responsible for collecting and transporting the solid waste from the camps into the agreed landfills. WV will provide solid waste collection and disposal in six IDP camps for 12 months, whilst AFH will provide such support at community level in Tell Abiad and Ras Al Ain (6,427 program participants) for eight months. WV will continue to maintain the dump site on a regular basis, including coverage of the garbage with soil to mitigate negative impacts on the surrounding environment (see Activity 2.3). In Azaz, WV will support WASH committees (see Hygiene Promotion subsector) to monitor this activity and ensure the safe disposal of solid waste to minimize public health risks.

Activity 2.3.2: Undertake compacting and preparation of landfill for solid waste disposal

Edkah landfill is within Azaz sub-district in close proximity to the 6 targeted IDP camps, and is also used by additional IDP camps and host communities such as Azaz city, Sejjo village and Shemareen village, benefiting a total of 80,000 individuals. The daily solid waste collection under Activity 1.3 is deposited into Edkah landfill. WV previously constructed the dump site six years ago, far from all settlements and camps, and prepared an access road to facilitate garbage transfer. The landfill has been used for many years and is in need of compacting and preparation works in order to ensure its continued suitability. Accordingly, WV will rent machinery such as loaders and compactors in order to compact the existing garbage and prepare the landfill for deposits of future garbage. This includes the coverage of the garbage with soil to mitigate negative impacts on the surrounding environment and health related issues from vector control.

Sub-Sector Name:

Water Supply

Activity List

Activity 2.4.1: Provide emergency water trucking to six IDP camps in Azaz sub-district in NWS

WV will provide emergency water trucking to the six targeted IDP camps in Azaz sub-district, serving 28,700 program participants. Water trucking is necessary in this region due to the limited groundwater resources in the area, and previous attempts by other organizations to drill have not produced sufficient yields. For example, in Al-Rayan Camp, the main borehole was producing 35m3/hr a few years ago, now only produces 10-12m3/hr due to the large drawdown by other unregulated wells and issues of natural replenishment of the aquifer. An average 25 liters/person/day will be supplied, as per the WASH cluster recommendations, to household water tanks or communal water points within a walkable distance (not more than 100m from the surrounding shelters) to allow easy access and transport for all community members. Camp population figures will be monitored and water quantities will be adjusted accordingly. In total, 21,883m3 of water per month will be provided by a local contractor who will be hired under this project following a competitive procurement process.

All water trucks will be collecting water from trusted water sources and treating it to ensure that water quality measures are met, including regular water quality testing done in parallel with the water trucking activity. Pool testers will be used to measure Free Residual Chlorine (FRC) and pH levels. The tests will be conducted by water technicians at water sources, communal water points, and household levels on daily basis to ensure that water quality delivered to the program participants is safe and according to Sphere standards, and WHO’s Water Safety Plan procedures.

Activity 2.4.2: Provide operational support, maintenance, and minor rehabilitation to two water stations in Azaz sub-district in NWS, two water stations in Idleb in NWS, and five water stations in Tell Abiad and Ras Al Ain in NCS

WV, IYD and AFH will conduct maintenance and minor rehabilitations for all targeted pumping stations where damage and wear and tear has been identified. The targeted water systems will serve both IDP camps and community settings (including IDPs living in the communities). All selected sites in NWS are supporting communities with a high number of IDPs (91% for Azaz camps and 49% in urban Idleb city). The stations in NWS are large in scale and have a large pumping capacity, whereas the five sites proposed by AFH in NCS (Tell Abiad and Ras Al Ain) are for vulnerable rural host communities with a small IDP population and are therefore simpler in comparison. The technical teams from WV and partners will conduct detailed technical assessments to prepare the rehabilitation needs and BoQs to be covered under this project. In general, operational support, fuel, oil, filters, and other consumables will be provided in addition to the regular maintenance required for generators, pumps and boreholes, to ensure the smooth operation of the pumping stations.

For WV, Al-Rayan and Shamareen water stations in Azaz district will have O&M costs including but not limited to maintenance for generators and submersible pumps, electricity and generator diesel fuel during an emergency and chlorine pumps for treatment. The pumping stations, including boreholes, submersible pumps and horizontal pumps cover 20% to 25% of the IDP settlements needs of the potable water as follows: Al-Rayan borehole submersible pump providing 60m3/hr for approximately 6.5 hours a day, and Shemareen booster pump at (5hp) providing 40 m3/hr for approximately four hours a day. In addition to O&M support, there will also be capacity building and feedback consultative meetings (upon AFAD and local council approval) arranged to serve as a knowledge sharing with local council, water station management and community focal points on various topics such as cost recovery, maintenance, and reporting.

For IYD in Idleb city, these facilities are particularly large, namely Sharie Althlathyn (105 m3/h) and Alghazl water station (100m3/hr) which operate for an average of 14 hours per day and provide improved water for 62,090 program participants. IYD will support 12 staff, namely two supervisors, two water station operators, four water network operators, and four guards for the O&M of these supply systems. Additionally, IYD will support with the provision of water quality testing kits, electricity for the running of the stations, oil for the pumps and foreseen emergency maintenance for the water stations. Idleb city suffers from frequent electricity cuts, thus making the fuel support for the generators particularly crucial.

AFH plans to support the running of five water stations in rural communities, with four in Ras Al Ain (Umirt, Tal Halaf, Manajir and Al-azizieh water stations), and one in Tell Abiad district (Al salheea water station) to the combined benefit of 12,652 individuals. Two of these five water stations are currently non-functional and would need to be first rehabilitated before operational support can be given. It is to be noted that upon project start, AFH will coordinate with the WASH Cluster, humanitarian actors and local authorities to agree on the exact water stations to be targeted, in case the situation might have changed and to retain flexibility to support the greatest needs. While rehabilitation and network expansions (Activity 2.4.3) are carried out, AFH is anticipating having to provide some temporary water during a short period while the network needs to be closed. AFH has also budgeted some emergency contingency of water provision for situations whereby the electricity is not being provided for multiple days and there are issues with accessing fuel to run the generators. AFH will also support these stations with operational materials such as fuel provision, oil for generators when needed and maintenance support. AFH will connect these stations with the electricity grid if available, and support the water stations with electric fees for three months. In terms of water quality, AFH will monitor the water quality on a daily basis at station level and HH level. Water quality monitors will conduct daily FRC and PH tests to ensure the water quality matches WHO standard and is safe for drinking. Some of these rural communities have been relying on expensive alternatives such as water trucking, or unsafe methods such as untreated surface water. This intervention will help these vulnerable communities with a safe and more sustainable drinking water solution.

Activity 2.4.3: Replace, repair, and expand water networks in NWS and NCS connected to supported pumping stations

Through this activity, WV and partners will work in the same locations where the rehabilitation of pumping stations activities in Azaz and NCS will be conducted to repair and expand the functional water networks, to the benefit of 41,352 program participants (28,700 program participants in NWS and 12,652 program participants in NCS). The activity will also entail the connection of all non-connected shelters in the vicinity to these expanded networks. WV and AFH technical teams will conduct an in-depth technical assessment to identify the exact repairs and expansion requirements needed, and prepare accurate BoQs accordingly. Local contractors will be hired under full supervision of WV and AFH engineers. This activity will be supported by Activity 2.4.2 which will focus on ensuring efficient piped water supply from the pumping stations that feeds into the repaired/expanded networks.

To improve and maintain the storage and supply networks from the water stations, eight small repairs and replacements of damaged water lines have been identified in Aleppo governorate (Azaz) and three locations in NCS. WV will expand the water network in the camp to help further transition this displaced community away from trucking to the HH level. AFH will repair, expand, and connect rural communities also dependent on trucking to existing supply lines, mainly in Ras Al In.

TPM Methodology

The TPM methods should combine quantitative and qualitative methods involving the relevant project stakeholders and beneficiaries at the community level. Data collection methods may include but are not limited to project document review (WVI will provide project documents), surveys with the target population in villages, Key Informant Interviews (KII) and focus group discussions (FGD) with main stakeholders.

TPM Objectives

The main objectives of the BHA WH-SCAD TPM exercise are to:

Ensure and verify that the project activities are implementing as planned.
Assess accessibility and beneficiary satisfaction of project services.
Assess accessibility of project resources for all community members;
Assess if project resources are efficiently and effectively used for the targeted communities and households;
Conduct direct observation and on-site verification of the WASH and Health implementation areas;
Assess effectiveness and coverage of current beneficiary feedback mechanisms in place
Identify implementation gaps and suggest recommendations.

1. Criteria

The proposed monitoring criteria are the following:

Availability of services:

Assessment of the extent to which WVI has met its service delivery commitments in the Work Plan (including staff, supplies and equipment, etc.) and the adherence to technical parameters and specifications, such as Bill of Quantities, and verification of progress

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