Technical assistance for an exploratory mission SRHR

Service context

Solthis is an international solidarity NGO whose aim is to improve the health of populations, particularly those most at risk, in countries with limited resources, and to strengthen their access to healthcare.

We focus on prevention, equitable access to quality healthcare and services for all, and respect for the rights of all, by sustainably strengthening healthcare systems and services in the countries where we operate. Our action is based on three modes of intervention : capacity building, operational research and advocacy. Historically, Solthis’ work focused on the fight against HIV/AIDS, before extending to other priorities such as sexual and reproductive health and rights (SRHR), infectious and emerging diseases, and the One Health concept. Solthis operates mainly in West Africa. In the area of SRHR, Solthis has been working since 2016 on the basis of its institutional positioning[1] and its SRHR intervention framework. The organization implements projects targeting different components of the SRHR care continuum (cervical cancer, comprehensive sexual education, maternal health, STI/HIV, GBV, etc.) and, taking into account the specific needs of certain audiences (adolescents and young people, sex workers, people living with HIV).

Solthis has been working in Sierra Leone since 2011. The organization has set up various projects to strengthen the healthcare system and to fight HIV/AIDS. In the country, access to sexual and reproductive health (SRH) services for adolescents and young women and men (AY) remains limited due to numerous obstacles (early marriage, taboos, low socio-economic status, lack of information and decision-making power, etc.), leading to early and/or unintended pregnancies, sexually transmitted infections, including HIV, and a high maternal mortality rate, particularly among adolescents and young women. In Sierra Leone, UNFPA counted 717 maternal deaths per 100,000 births in 2019[2] , one of the highest rates in the world, and an estimated 40% of these occur among adolescent girls[3] .

Based on these needs, Solthis submitted a concept note to AFD (French Development Agency) which was accepted. The proposed project aims to contribute to improving access to and quality of SRH services and SRH rights for young people and adolescents, particularly young women and adolescent girls, aged between 10 and 24. The project is to be implemented in the districts of Western area urban, Western area rural, Kambia and Makeni. The planned intervention revolves around 3 expected results :

• Outcome 1: Young people and adolescents in target areas have improved their knowledge and ability to express their choices and preferences regarding SRH, nutrition and gender equality.
• Result 2: SRH care and services are better adapted to the needs of adolescents and young people, their quality and access are improved, and the skills of SRH workers in health and community structures are strengthened in the intervention zones.
• Result 3: National, local and community stakeholders adopt, influence or contribute to the adoption of policies more favorable to SRHRAY.

Among the thematics targeted by the intervention are the development of specific activities for the prevention and management of unitended pregnancies, the monitoring and support of early pregnancies, and the analysis and prevention of gyneco-obstetric violence (GOV), notably through the introduction of humanized childbirth models.

With this in mind, Solthis is looking for an international or national consultant to carry out an exploratory mission in the field of SRHR in the country. This will enable us, on the basis of the concept note already drawn up, to collect the main elements needed to draw up a complete proposal.

The consultant is expected to work closely with the Solthis Country Director based in Freetown.

Duties and responsibilities

The consultant will perform the following tasks:

1. Prepare the various tools needed to implement the mission, based on existing Solthis tools
2. Complete the analysis of stakeholders and technical partners involved in the field of SRHR in the country and zone (international and local NGOs, groups/coalitions, research institutions, professional associations, institutional partners, etc.) :
   • Complete the mapping of stakeholders (particularly in the areas of GOV/humanized childbirth, GBV, /abortion) and identify the main safe, resource centers for young people, especially pregnant girls.
   • Deepen knowledge of the two civil society organizations (CSOs) already identified for the project and of other potential partners in the field
   • Meet with health authorities and complete analysis of SRHR policies and strategies (national and regional/district)
3. Carry out exploratory visits to 3-4 health facilities in the target zone, including a rapid assessment of the situation in health centers and interviews with health professionals.
4. Carry out focus groups and interviews with target audiences and key community stakeholders in order to highlight the priority SRHR needs identified by the target audiences (youth, girls, pregnant girls and HIV-positive girls).
5. Lead 1-day workshop including presentation of preliminary mission results and reflection on future intervention with key partners and Solthis team members (mixed face-to-face/remote).
6. Lead a 1/2-day workshop with Solthis head office and field teams to present the final results (mixed face-to-face/off-site).

Estimated timetable which the consultant may propose to amend :

1. Tools preparation / 1 day / Distance learning
2. Briefing – head office and field scoping meeting / ½ day / Distance learning
3. Field mission / 7 days / In Sierra Leone
4. Meetings with partners (CSOs, UN agencies, health authorities, etc.) / 2 days / In Sierra Leone
5. Exploratory visits to healthcare facilities / 2 days / In Sierra Leone
6. Focus groups and community interviews / 2 days / In Sierra Leone
7. Workshop to share provisional results and strategy with partners / 1 day / In Sierra Leone
8. Report writing / 2 days / Distance learning
9. Workshop to present final results from headquarters and the field / ½ day /Distance learning

Expected deliverables

• Methodological framework for the mission, including timetable and proposed partners to be met
• Mission report including :
  • Mission report, list of partners and stakeholders met
  • A narrative presentation of the intervention context in which the future project is to be implemented, the specific issues to which the project should respond and the proposed intervention strategy (based on the results of the partnership workshop), as well as very concrete elements on the articulation and complementarity of the future project with public policies (national, decentralized and/or local) and the interventions of other players in progress, if relevant.
  • A logical framework (including objectives, results and activities, as well as the indicators that might be relevant to monitor and the means of collection)
  • Appendix: updated tools and documents collected (including protocols, policies and demographic data).

Expected profile of the consultant.

• Training in project management and development, public health, infectious diseases. Medical and/or paramedical training appreciated.
• At least 5 years’ experience in designing and implementing SRH projects in West Africa.
• Specific experience in sexual and reproductive health and rights
• Experience of working in Sierra Leone highly appreciated.
• Fluent English and working French.

Conditions

Job location :

Freetown and possible regional travel, with some remote work.

Contract duration :

Between 10 and 12 days of service. Ideally during the second half of October 2023 or early November.

[1] https://www.solthis.org/wp-content/uploads/2021/07/solthis-note-de-positionnement-dssr-2.pdf

[2] https://sierraleone.unfpa.org/en/who-we-are

[3] Bash-Taqi R, Watson K, Akwara E, Adebayo E, Chandra-Mouli V, From commitment to implementation: lessons learned from the first National Strategy for the reduction of teenage pregnancy in Sierra Leone. Sex reproductive health matters. 2020;28(1):1818376.