The overall purpose of this assignment is to conduct a FP SBCC formative assessment detailing county and sub-county specific FP situation, identifying with evidence and insights the barriers to access, uptake and utilisation of FP services (the behaviour problems), their root causes and a range of recommendations for action. Additionally, the assessment should detail out opportunities for implementing social behaviour change communication interventions including settings under which various audiences and stakeholders can be targeted and available and appropriate channels of communication and influence for different audiences. It is anticipated that the assessment will include an analysis of gender and the dynamics of gender-related power and socio-cultural issues that are often create barriers to accessing and utilising FP services and products.
The specific objectives of the assessment:
* Provide an understanding of the specific socio-cultural and religious barriers “behaviour problems’’ to access, uptake and utilisation of modern family planning methods
* Identify opportunities, strategies and communication channels for delivery of targeted and tailored social behaviour change communication messages to increase uptake and utilisation of modern family planning methods
* Provide information to guide development of County FP SBCC strategy for enhancing demand generation of FP services
* Provide analysed information of the “FP behaviour problems” that can be used in development of tailored SBCC interventions for specific target audiences
* Provide information to support development of county plans for FP and other integrated health plans where these are yet to be developed
A mixed methods approach is proposed in the implementation of this formative assessment. Although mainly qualitative, the assessment will also extract relevant FP demand side qualitative data from available literature. This section of the terms of reference briefly outlines proposed methods and approaches. Consultants recruited for the assignment are encouraged to suggest other additional innovative methods and approaches for implementing the assignment.
The following methods are proposed:
* Literature review to provide background on key FP indicators at national and county level, as well as sub-county levels where data is available
* Conduct key informant interviews/panel discussions with Sub-County and County health management teams, service providers and partners implementing FP programs especially those focussed on demand generation
* Key informant interviews with religious and traditional leaders in the targeted counties and with prospective FP communication service providers including FM radio stations and others where these exist
* Focus group discussions with women of reproductive age including adolescents as well as with boys and men, and other SRH “significant others” including mother in-laws in some targeted counties
* Conduct participatory formative assessment findings validation meeting
Tasks and deliverables:
* Develop a brief approach paper including conceptual framework for the implementation of the FP SBCC formative assessment.This will be signed off by the respective county and ESHE
* Develop FP SBCC formative assessment data collection tools including key informant interview and focus group discussion guides for the various categories of respondents.These will be signed off by the respective county and ESHE
* Train FP SBCC formative assessment teams including FGD and key informant interview facilitators
* Conduct and analyse the FP SBCC formative assessment data collection and develop draft summary of findings
* Conduct participatory FP SBCC formative assessment validation meeting and develop draft and final FP SBCC formative assessment report
Required qualifications and skills:
In implementing this assignment, ESHE will hire an international or national level expert who will work with a team of local research assistants or county ministry of health staff where possible to conduct the formative assessment.
The expert will be required to meet the following qualifications and skills:
* At least a Master’s degree or equivalent level in public health disciplines, social sciences, anthropology or similar training
* At least 12 years of professional experience in public health or social development. Those with experience in conducting family planning and reproductive health formative assessments will have an added advantage
* In-depth understanding of the traditional and societal make-up of Kenya, especially in rural and traditional counties where women are girls are most marginalised
* International experience preferable, especially providing similar types of social inclusion TA in devolved structures
* Experience of providing TA in difficult environments, including Kenya’s arid lands, is a distinct advantage
* The ability to liaise with senior MOH officials and dignitaries and members of the county health teams
* Fluency in spoken English and excellent writing skills in plain English are required. Candidates must have proven experience in writing high quality reports for similar assignments.
* Excellent facilitation skills and experience in carrying out effective community engagement interventions
* Good research skills
* Good team player with experience in stakeholder engagement
* Ability to deliver high quality work in short periods of time
* Ability to synthesise lots of complex information and stakeholders’ views into easy to understand text
Length of assignment:
The total level of effort for implementing the formative assessment is estimated at 25 days depending on the county situation. Prospective consultants will be required to outline their proposed level of effort to implement the assignment tasks as outlined in these terms of reference. The assessments are expected to begin mid-July and may continue until end October 2018 based on the needs and schedules agreed with the various targeted counties.
About the Organization
Palladium is a global leader in the design, development and delivery of Positive Impact - the intentional creation of enduring social and economic value. We work with foundations, investors, governments, corporations, communities and civil society to formulate strategies and implement solutions that generate lasting social, environmental and financial benefits.
For the past 50 years, we have been making Positive Impact possible. With a team of more than 2,500 employees operating in 90 plus countries and a global network of more than 35,000 technical experts, Palladium has improved - and is committed to continuing to improve - economies, societies and most importantly, people's lives.
Palladium is a child-safe organisation, and screens applicants for suitability to work with children. We also provide equal employment to all participants and employees without regard to race, color, religion, gender, age, disability, sexual orientation, veteran or marital status. About ESHE:
The ESHE family planning programme is supported by DFID and managed by Palladium. The intended impact of the ESHE FP programme is increased use of FP among women of reproductive age including adolescent girls, and the expected outcomes are greater access to more FP choice, including for the poorest Kenyans.
The programme is underpinned by four outputs namely:
* Output 1: Increased access, choice and quality of FP
* Output 2: Increased awareness for FP and reduction of socio-cultural barriers
* Output 3: Greater involvement and sustainability of the private sector
* Output 4: Total Market Approach3 (TMA) for FP effectively planned, coordinated and supported
In collaboration with partners, ESHE has reach in 40 counties. The programme provides a range of client-focussed and high-quality services and products through both the public and the private sector; scale up demand for services and break-down socio-cultural barriers that can prevent women and girls from using family planning. We place importance on strengthening health systems to ensure availability, access and utilisation of quality FP services. As a technical assistance programme, ESHE partners closely with the national and county Ministries of Health. Palladium provides technical support through its core team of staff and also through expert consultants who are hired to provide technical assistance on specific short-term assignments.
Background to the assignment:
In counties in northern Kenya, FP use is low for many reasons. On the demand side, many barriers exist that are related to socio-cultural attitudes and practices, which includes traditional views, gender and power dynamics between men and women, as well as religious beliefs. These barriers are widespread, highly complex and deep-rooted. Such social determinants of FP have been around for many years. Given how complicated such barriers – and the reasons for these barriers to exist – are, a different approach is needed to tackle them. More traditional SBCC interventions are not effective in such settings.
Several counties in northern Kenya have asked ESHE for technical support to help them better understand the social determinants of FP, including the extent of socio-cultural, traditional and religious barriers. Key counties include Garissa, Mandera, Wajir and the northern sub-counties of Baringo.
Counties have asked for this support as they want to increase FP programming and they recognise that such issues are key barriers to more FP uptake in the counties. However, many counties do not have up to date information and specific analysis to use to inform their programming. In some counties, studies on the acceptability of traditional FP methods from almost a decade ago are the most recent data and analyses that are available to inform programming decisions. In other counties, there are no study findings available at all. General anecdotes and insights on the problems are cited often (e.g. “male involvement is low” or “men will not support FP unless a cleric has openly given permission for it to be used”) but these are not sufficient to enable well-informed programming to take place, or to inform a county-specific SBCC strategy to be developed.
To respond to these requests from our focus counties, the ESHE program seeks services of experienced SBCC technical experts to lead the county specific FP formative assessments. The assessments may be carried out more rapidly in some counties than others – depending on the needs of the counties the purpose for use of the assessments.