CARE
Introduction and Background: CARE International has been in operation in Somalia/Somaliland since 1981 implementing both Humanitarian and Development programs. Over the years, CARE International has forged strong working relationships with local communities and authorities throughout the country. Building on its commitment to strengthen local capacities and emphasis on local actions and solutions to local issues, CARE is working with 19 national NGOs to provide Humanitarian and longer-term development assistance across different regions Somalia/Somaliland.
CARE is registered with both the Somali Federal Government, all member States and partners with government (Somalia Federal Government and member states), line ministries and/or departments including Ministry of Health as well as the UN (WHO, UNFPA, UNICEF, WFP) for the implementation of Health and Nutrition programs. CARE’s emergency response focus on the needs of the most vulnerable populations, particularly girls and women. CARE implements its emergency response through Health & Nutrition, Education in Emergencies, Protection, Water, Sanitation and Hygiene (WASH), Food security and livelihood sectors with aim of providing a holistic response to the multiple needs of the most vulnerable in the community.
Somalia has had decades of protracted disasters that has negatively affected almost social sectors including health. The health care system in Somalia remains weak, un resourced and inequitably distributed and clustered around major cities. There is critical shortage of health workers leading to most seeking service from unregulated private health facilities. As a result, around 3.2 million women and men in Somalia/Somaliland need emergency health services. According to UNICEF’s report on the situation analysis of children in Somalia/Somaliland 2016, children and women face more health challenges in Somalia/Somaliland than in almost any other of the world’s countries.
Pregnant women and Girls are faced with myriad of sexual and reproductive health challenges emanating from social, economic and physical barriers to health. According to Somalia demographic health survey 2020, only 21% of mothers get the opportunity of delivering at a health facility with support from a skilled health worker. As a result, Somalia’s maternal mortality is estimated to be over 692/100,000 live births which is one of the highest globally.
Health and Nutrition sectors are key areas of humanitarian interventions for CARE among drought affected and displaced communities in the regions of Lower Jubba, Galmudug, Sool, Sanaag, Bari and Togdheer. Over the years CARE has built its technical and partners’ expertise and systems to ensure quality and timely service delivery to the populations who are in need and experience frequent shocks (climate related and human). Operating under a Memorandum of Understanding (MOU) with the regional Ministries of Health (MOH) of Somaliland, Puntland, Galmudug and Jubba Land, CARE directly supports a network of MOH health facilities, building MOH institutional capacity in service delivery, monitoring, and co-ordination. CARE’s integrated primary health care approach aims to bolster Somalia’s/Somaliland fragmented primary health care system by strengthening MoH’s health system stewardship capacity in the delivery of the essential package for health services (EPHS).
Over the last two years CARE has put stronger emphasis in quality programming in the Health and Nutrition sectors among other program sectors through improved joint supervision, capacity building of its staff and partners in Health and Nutrition and data quality audits. However, gaps exist in terms of access and utilization of sexual and reproductive health services among women and Girls in CARE’s project sites. While CARE has put emphasis on equipping Maternity units and Maternal child health (MCH) clinics with essential equipment and supporting referral services, utilization of maternal health including gender-based services is low.
To get a better understanding of this and inform its sexual and reproductive health component, CARE seeks to engage a short-term consultant to study the barriers to women and Girls accessing and utilizing sexual reproductive and gender services in project area. CARE will use the gaps identified to develop quality, gender responsive programs to improve sexual and reproductive health services among the vulnerable women and children.
Purpose of the Terms of Reference (TOR):
Overall goal and objectives of the assessment:
The overall aim of the study is to explore and understand the barriers vulnerable women and Girls face in seeking and obtaining skilled, quality sexual and reproductive health services by assessing knowledge, attitudes and practices at community and facility level in Somaliland, Puntland, Galmudug and Lower Jubba of Somalia.
The specific objectives are:
The study will guide an evidence-based implementation strategy for CARE’s sexual and reproductive programs including that aims to improve maternal and child health outcomes.
· Identify health facility level factors affecting access to sexual and reproductive health for women and Girls in Somaliland, Puntland, Galmudug and Lower Jubba of Somalia.
· Assess and describe barriers and facilitators of sexual and reproductive health for vulnerable women and Girls at the community level.
· Identify perceptions, cultural beliefs, attitudes, and knowledge of the community about sexual and reproductive health for women and Girls including Gender based violence (GBV) and family planning.
· Identify staff skill and knowledge hindering provision of sexual and gender based violence service ah Health Facility
· Study area
The survey will be conducted in Lascanood, Erigavo, Ceel afweyn, Badhan, Dhusamareeb, Cabudwaq, Dhobley and Afmadow Districts where CARE is implementing Sexual and reproductive health services integrated into health and nutrition projects.
· Study population
Women & Girls, Health committees, Health Facility staff and of reproductive age will be interviewed to ascertain barriers to access and utilization of sexual and reproductive health services.
· Study Methodology
The consultant is expected to propose and an appropriate study design involving both quantitative and qualitative data collection entailing beneficiary survey, Health Facility document reviews, focused group discussions, beneficiary, key informant and stakeholder interviews.
· Consultant role and responsibility
Ø Develop and design study protocol and questionnaires, including sample size estimation, population size, clustering of the villages and validate contextual tools
Ø Assume overall responsibility for design and implementation of the Knowledge, Attitude and Practice (KAP), including daily supervision of KAP teams and daily data collection quality assurance
Ø Train the KAP data collection teams and data clerks in data collection standards and use of the tools (including field testing)
Ø Implement the KAP survey in Sool, Sanaag, Bari, Galmudug and Lower Jubba
Ø Be responsible for data cleaning and analysis using appropriate software (i.e. Epi Info, SPSS, ENA for SMART, and ODK).
Ø Prepare a draft assessment report for review by CARE team ensuring that the assessment is comprehensive and includes all relevant indicators
Ø Prepare and lead a validation workshop (debriefing) for CARE and partners team
Ø Prepare a final report including background, methodology, results, limitations, conclusions, and recommendations incorporating feedback from CARE Somalia staff and other Nutrition stakeholders on the draft report and tools.
· CARE’s role and responsibilities
Ø Facilitate logistic arrangement including travel, accommodation etc.
Ø Recruit Enumerators
Ø Mobilize the target groups for interviews
Ø Provide input to the inception report, tools and KAP draft report
· Activity plan.
No
Activity
Number of days per camp
1
Preparation of survey tools, inception report and sharing with CARE and finalization after feedback
4 days
2
Validation of tools and presentation to cluster and Ministry of Health
2 Day
3
Training of survey enumerators and field testing
2 days
4
Data collection (Quantitative and qualitative)
4 days
5
Data cleaning and analysis
4 days
6
Report Writing
5 days
7
Technical review and comments by CARE team
2 days
9
Final Report
2 days
Total Days
25 Days
· Deliverables.
Ø Inception report that includes the design, implementation and supervision strategy of the assessment including data collection tools
Ø COVID 19 adherence plan
Ø Data Collectors training power point
Ø First draft assessment report including raw data set in SPSS
Ø Submit power point presentation of key finding
Ø Final detailed report with recommendations with emphasis on among others on how;
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key barriers social and traditional barriers to gender and sexual health for women and Girls.
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Increased equitable use of health services by diverse groups of women and adolescent girls.
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Improved provision of gender-responsive, inclusive and accountable health services by health care providers for diverse groups of women and adolescent girls.
· Qualifications:
Ø Advanced degree in Reproductive health, Public Health, Nursing or related field**
Ø At least 7 years of consulting experience at national or international levels in sexual and reproductive health assignments.**
Ø Prior experience working on research specific to sexual and reproductive health**
Ø Prior experience working with youth and women**
Ø A minimum of 5 years of experience in conducting quantitative and qualitative research**
Ø Knowledge of gender-sensitive approaches**
Ø Excellent communications skills in English, including advanced writing skills**
Ø Strong communication skills in Somali preferred**
Ø Direct experience working with women and girls in diverse communities in Somalia**
Ø Experience in qualitative research will be an added adavntage**
· Application Requirements. **
The below requirements will be considered as part of the selection process and therefore, all interested applicants are encouraged to send.**
Ø A technical and financial proposal: Should highlight their understanding of the ToR and how they propose to respond to the ToR requirements including the evaluation design, tools and technologies in place for them to perform the assignment, implementation plan and financial quote.
Ø Team structure: Details of consultant’s capacity and how they structure the evaluation team. This also includes the CVs of key evaluation teams including the lead consultant(s).
Ø Sample work: At least three (3) samples of similar work (operational gender and sexual health study reports) performed for peer organization in Somalia or in the Horn of Africa region for the last 3 years.
Ø References: Names and contact details of at least three (3) organizations with whom similar work has been performed.
NB: Proposed key personnel used for bidding are expected to be the people executing the work of this contract.
· Duration of the Assignment.
Ø The duration of the assignment is 25 working days after signing of contract. Days are inclusive of travelling, fieldwork and reporting.**
How to Apply.
All applications MUST be accompanied by a technical and financial proposal including a brief outline of the proposed methodology, 3 references with contact details, a tentative work plan and the candidate’s availability.
Interested consultants or firms are expected to submit their applications, updated CVs of individuals to conduct the study or profile of applying company to: [email protected] .Please indicate “Study on barriers to gender and sexual health seeking behaviors ’’ as the subject heading not later than 3rd March 2022
CARE is an equal opportunity employer promoting gender, equity and diversity. Female candidates are strongly encouraged to apply. Our selection process reflects our commitment to the protection of children from abuse
How to apply
How to Apply.
All applications MUST be accompanied by a technical and financial proposal including a brief outline of the proposed methodology, 3 references with contact details, a tentative work plan and the candidate’s availability.
Interested consultants or firms are expected to submit their applications, updated CVs of individuals to conduct the study or profile of applying company to: [email protected] .Please indicate “Study on barriers to gender and sexual health seeking behaviors ’’ as the subject heading not later than 3rd March 2022
CARE is an equal opportunity employer promoting gender, equity and diversity. Female candidates are strongly encouraged to apply. Our selection process reflects our commitment to the protection of children from abuse