Call for Proposal: Evaluation of The MSF Academy for Healthcare Nursing Initiative in Sierra Leone (Kenema) and South Sudan (Old Fangak)

Doctors Without Borders/Médecins Sans Frontières (MSF) is an international medical humanitarian organization determined to bring quality medical care to people in crises around the world, when and where they need regardless of religion, ethnical background, or political view. Our fundamental principles are neutrality, impartiality, independence, medical ethics, bearing witness and accountability.

The Stockholm Evaluation Unit (SEU), based in Sweden, is one of three MSF units tasked to manage and guide evaluations of MSF’s operational projects. For more information see: evaluation.msf.org.

Promoting a culture of evaluation is a strategic priority for MSF in order to be accountable, seek for continuous improvements and achieve organizational learning. MSF does not evaluate only because of external requirements, for example donors related ones. These Terms of Reference should be seen as a starting point for the evaluation process. The evaluator(s) are welcome to challenge them and suggest for example different or additional perspectives, as they see fit during the inception phase. The evaluation process should rely on solid methodology to achieve credible results and should also ensure to put values and use in the forefront. The evaluation must involve and include different actors and counterparts in an adequate manner during the whole process.

Name of evaluation: Evaluation of The MSF Academy for Healthcare Nursing Initiative in Sierra Leone (Kenema) and South Sudan (Old Fangak)

Starting date: July 2022

Duration: Final report to be submitted by October 2022

Terms of Reference: https://evaluation.msf.org/evaluation-msf-academy-healthcare-nursing-initiative-sierra-leone-kenema-and-south-sudan-old-fangak

Requirements: Interested applicants should submit: 1) A proposal describing how to carry out this evaluation (including budget in a separate file), 2) a CV, and 3) a written sample from previous work

Other: Data collection in field to be discussed during inception phase, knowing evaluation focuses on Kenema, Sierra Leone and Old Fangak, South Sudan.

BACKGROUND The MSF Academy for Healthcare (MSF Academy) is an intersectional learning initiative within MSF that focuses on strengthening the skills and competencies of frontline healthcare workers in the countries where MSF operates. MSF provides both short-term and longer-term humanitarian medical assistance in more than 70 countries, employing both local and international medical and non-medical staff to carry out the organization’s mandate. The MSF Academy currently implements five initiatives: Nursing & Midwifery, Antimicrobial Resistance Learning, Outpatient Care, a Post-Graduate Diploma in Infectious Diseases and a Fellowship in Medical Humanitarian Action. MSF Academy’s training programmes are based on three pedagogical pillars: competency-based curriculums, workplace training, and clinical mentoring. This evaluation focuses on the Nursing Initiative and more specifically on the field implementation of its Basic Clinical Nursing Care (BCNC) programme. It is a two-year long learning programme for nationally employed staff performing nursing duties in MSF-supported hospitals. The overall objective of the BCNC is to strengthen skills and competencies of staff providing nursing care in all participating hospitals, with the aim to contribute to a sustainable improvement in the quality of care. The BCNC curriculum is composed of five modules, for a total of 40 learning units which can be progressed through at different speeds. Learning tools include theoretical handouts, learning activities (such as videos, interactive games and quizzes) and practical sessions such as role-plays and skills practice. The learning strategy is adapted to the situation of running MSF hospitals and mixes theoretical and practical sessions, completed with bedside teaching. Learners are provided with personalized clinical mentorship support and individual follow-up throughout the programme. The BCNC was developed from the end of 2018 and by mid-2022 it has been rolled out in several MSF projects in Sierra Leone, Central African Republic, South Sudan and Mali, run by five MSF Operational Centers (OCA, OCB, OCBA, OCG, OCP)2. The starting date for programme implementation and the pace at which learners progress through the programme vary from one project to the other: mid-2022, the BCNC sees its first graduates in Kenema, Sierra Leone (OCB project – 28 graduates) and Old Fangak, South Sudan (OCP project – 35 graduates). The evaluation should focus on those two projects as students enrolled in the other projects have not yet completed the full programme.

PURPOSE & INTENDED USE PURPOSE The purpose of the evaluation is to assess the value of the BCNC programme in Kenema and Old Fangak. Ultimately key stakeholders want to know if the programme is worth the investment (efforts, time, resources). 1 Source: MSF Academy Activity Report 2021, 2020 and 2019. See www.msf.org/academy 2 standing for Operational Centres of Amsterdam, Barcelona, Brussels, Geneva and Paris.

INTENDED USE The evaluation will provide evidence and lessons learned that will be useful for the future programming and roll-out of BCNC. It will also inform upcoming intersectional decision-making regarding further investment in the initiative. Beyond the BCNC, the evaluation might provide useful insights for the other programmes of the MSF Academy, as well as a broad range of stakeholders within MSF.

EVALUATION CRITERIA & QUESTIONS The below questions should be seen as a basis from which the successful candidate(s) will develop the questions further. EQ1. In Kenema and Old Fangak, was the BCNC needed, and did it address the most important root causes? EQ2. How well designed and implemented was the BCNC in Kenema and Old Fangak? EQ3. How effective was the BCNC in achieving its objectives in Kenema and Old Fangak? What were the reasons for achieving or not these objectives, enabling factors or barriers? How valuable are the outcomes for the students and their workplace? What worked best, for whom, under what conditions and why? EQ4. How worthwhile was the BCNC overall in Kenema and Old Fangak? Which parts or aspects generated the most value given the investments (time, money, efforts)? Have resources been deployed sufficiently and utilized efficiently? EQ5. What is the impact of the BCNC in Kenema and Old Fangak? How sustainable is it? Are they any unintended consequences, positive or negative? What are the perceptions of different stakeholders on the value of the BCNC? EQ7: What are the perspectives of replicability of the BCNC in a successful manner in other contexts?

EXPECTED DELIVERABLES

1. Inception Report As per SEU standards, after conducting initial document review and preliminary interviews. It will present how the evaluation will be conducted.
2. Draft Evaluation Report As per SEU standards. It will answer to the evaluation questions and will include conclusions, lessons learned and recommendations if any.
3. Working Session With the attendance of commissioner and consultation group members. As part of the report writing process, the evaluator(s) will present preliminary findings, and facilitate discussion around those. Ideally, the working session will also include a co-creation of the recommendations.
4. Final Evaluation Report After addressing feedbacks received during the working session and written inputs on the draft.
5. Webinar to MSF Academy (both executive team and Programme Board) and beyond, presenting and discussing evaluation findings. Other dissemination deliverables to be suggested and defined during evaluation process. See Dissemination and intended use below for suggestions.

TOOLS AND METHODOLOGY PROPOSED In addition to the initial evaluation proposal submitted as a part of the application (see requirement chapter), a detailed evaluation protocol should be prepared by the evaluators during the inception phase. It will include a detailed explanation of proposed methods and its justification based on validated theory/ies. It will be reviewed and validated as a part of the inception phase in coordination with the SEU.

RECOMMENDED DOCUMENTATION ▪ MSF strategic documents eg Strategic Orientations, Operational Prospects, Strategies (Medical, HR, L&D), with focus on OCB and OCP. ▪ MSF Academy Activity reports, plans and background papers, assessments, monitoring, evaluation, and reporting, MoU or other agreements with MoH for example. ▪ Documentation from hospitals in scope of the evaluation (Kenema and Old Fangak), and their project documents. ▪ External literature and documentation of similar experiences

PRACTICAL IMPLEMENTATION OF THE EVALUATION

Number of evaluators: One or several evaluators – a team can be assembled by the SEU of individual applicants where necessary.

Timing of the evaluation: July to October 2022

PROFILE/REQUIREMENTS FOR EVALUATOR(S) ▪ Requirements: o Proven competencies in evaluation o Expertise in the area of adult learning and specifically continuous professional development. o Fluent in English ▪ Assets: o Academic background in education, adult learning o Experience of training/learning for health professionals o Nursing background o Knowledge of the contexts in which BCNC is rolled out o MSF experience and/or understanding, humanitarian experience

DISSEMINATION AND INTENDED USE: see link to ToRs – dissemination and intended use table