Health and Nutrition Knowledge, Practices and Coverage Household Survey Analysis and Report Consultancy 2023

Job Description

Location

Remote position

Starting Date & Initial Contract Details

ASAP. Around 17 days

Summary

Funding to support Medair’s Health activities comes from an array of European donors, of which German Federal Foreign Office “Auswärtiges Amt in German” and Swiss Agency for Development and Cooperation of the Federal Department of Foreign Affairs (FDFA) are the primary donors. The current funding cycle extends from 2023-2025.
The current health project activities are designed to:

1. Improve access to primary health care and vaccination services, particularly for women and children under five.
2. Improve the quality of health care services provided by supported healthcare facilities
3. Increase community knowledge and practice of improved health, nutrition, and hygiene behaviours, particularly among families with children under five
4. Increase access to psychosocial support in the community and mental health services in PHC facilities.
   Key project areas under these objectives include supporting health behaviours among families with children under 5 years of age including:
5. Health seeking behaviour
6. Diarrhoea and respiratory tract infection management for children
7. Vaccinations
8. Reproductive health management
9. Infant and Young Child Feeding (IYCF) practices
10. Access to reproductive and psychosocial services.
    To track performance against project indicators (Annex 1), a standardized annual Knowledge, Practice, and Coverage (KPC) household survey is applied to a random sample of mothers – both Syrian and Lebanese – in the Medair supported PHC project areas. Medair conducted its first KPC survey in November 2015 and has repeated the survey each year. The survey data tracks project indicator progress and also provides evidence for Medair, MOPH and donors regarding the maternal and child health situation in the Bekaa valley and other areas of interest and further inform future decision-making, advocacy, and programming.
    This year with the change of the targeted facilities and areas the KPC will be used as a baseline of the 39 indicators (Annex I). For supported clinics, the indicators will be compared later to the end of project findings provide suggestions for adaptations or new programming approaches whilst for non-supported clinics provide evidence-based data for community health needs and gaps for service provision.

Funding to support Medair’s Health activities comes from an array of European donors, of which German Federal Foreign Office “Auswärtiges Amt in German” and Swiss Agency for Development and Cooperation of the Federal Department of Foreign Affairs (FDFA) are the primary donors. The current funding cycle extends from 2023-2025.

The current health project activities are designed to:

1. Improve access to primary health care and vaccination services, particularly for women and children under five.
2. Improve the quality of health care services provided by supported healthcare facilities
3. Increase community knowledge and practice of improved health, nutrition, and hygiene behaviours, particularly among families with children under five
4. Increase access to psychosocial support in the community and mental health services in PHC facilities.

Background

In 2014, Medair began supporting the health centres within the Ministry of Social Affair’s (MOSA’s) Social Development Centres (SDCs), in addition to implementing an extensive community outreach programme through Community Health Volunteers (CHVs) and Community Midwives (CMW). Medair has supported ten different SDCs in the Bekaa/Baalbek region since 2014, however in 2022 Medair shifted focus to support primary health care (PHC) facilities within the Ministry of Public Health’s (MOPH) network, in line with the national strategy. Medair supports the clinics through the provision of human resources, medicines, equipment, capacity building and technical supervision to each of the clinics. Medair seeks to improve access to PHC including Mental Health and Psychosocial Support Services, through decreasing financial barriers, increasing quality of available services and improving community resilience through increased knowledge and practice of preventive and curative health, nutrition and hygiene behaviours. Currently Medair supports two PHCs in Serraine and Deir Al Ahmar and is looking to extend funding to other areas in Central Bekaa and South Lebanon.

The Consultancy

The purpose of the survey is to provide baseline data against which project achievement will be measured, and highlight priority areas of need within target communities, providing a strong evidence base for future funding proposals.

Objectives:

1. Assess the knowledge, coverage and practices related to health, MHPSS and nutrition among refugees and vulnerable Lebanese in the project targeted communities disaggregated by governorate, nationality, and health facility.
2. Provide robust recommendations on each of the survey dimensions by triangulating survey data, area service mapping and inputs from the project team.

Outputs:

Following the completion of the survey in September 2023 and subsequent data cleaning by Medair, the expected outputs of the KPC consultancy are:

1. Conduct data analysis of all required indicators (Annex I) using appropriate software, in relation to program coverage areas respectively and as per the standard indicator definitions and guidance supplied in the plan of analysis. All indicators and their disaggregation should be presented with confidence interval. A summary of results for all indicators in excel, their disaggregation and confidence interval in excel table format to be shared by the consultant after analysis for data validation, prior to receiving the final report draft. SPSS or any other software outputs should be delivered and will be used in the validation of the findings.
2. Draft a comprehensive report (following the KPC module 3 guidelines (Annex III)) that describes the baseline survey’s results, discusses its findings (with input from Medair’s Health & Nutrition Advisor, Medair MEAL Advisor, Health & Nutrition Project Managers, MEAL Project Manager and other senior management) and presents recommendations for programme adaptation in consultation with sectoral staff.
3. Incorporation of inputs from Medair staff, and proofreading of the final report
4. Presentation of preliminary findings in an online workshop to help in the interpretation of the findings
5. Complete final report
6. Outline the data for infographic pager in coordination/consultation with Medair sectoral staff (Health & Nutrition and MHPSS PM, MEAL PM)

Activities:

• Statistical analysis of KPC data using descriptive statistics and associated confidence interval
• Presenting preliminary findings to Medair Lebanon country office
• Writing final report, outlining key findings, recommendations and lessons learned in relation to the indicators outlined herewith, and with appropriate age disaggregation
• Finalise the report in response to feedback from Medair technical advisers
• Create an infographic one-pager summarising key findings, recommendations and lessons learned

Scope:

The Knowledge, Practice and Coverage (KPC) household survey will measure standardized health and nutrition indicators for Syrian refugees and vulnerable Lebanese, in Medair project areas. The survey will include indicators from standard KPC modules (breastfeeding and infant/child nutrition, growth monitoring and maternal/child anthropometry, childhood immunization, sick child, diarrhoea, prenatal care, delivery and immediate newborn care, postpartum care and child spacing) in addition to background information and needs assessment questions.

Methodologies & Tools:

The KPC household survey is a community-based survey where data collection occurs in the field. The area of interest are vulnerable neighbourhoods who are potential customers of the primary health care facilities. It will be conducted with Syrian refugees living in informal settlements and vulnerable Lebanese in 2 locations, Bekaa and South Lebanon. It will target women with children under 5 years of age, with mothers of children under 2 years of age being a subgroup of interest to respond to many indicators. Sampling will be stratified based on the nationality. For Syrians, all the informal settlements within 10km of the health facilities or are target of Medair outreach activities will be considered as clusters and constitute the sampling frame. Cluster sampling of the informal settlement will be done proportional to population size at random and households within each settlement will be then selected using systemic random sample. Similarly for Lebanese, the sampling frame will be constructed based on their proximity to the health facilities (within 10 km of the health facility) and are either regular beneficiaries of the facility or might be in the future after being supported. Cluster sampling proportional to population size will be used to achieve 95% confidence interval and 5-10% margin of error at health facility level. Verbal informed consent will be sought from respondents at the starting of the KPC survey.

Data collection in the field will be conducted with trained enumerators with health and nutrition backgrounds, the MEAL team will be conducting two-day trainings on the objective and scope of KPC as well as on the questions, it’s expected that 24 enumerators are needed to fulfil the work within 4 days in the field.

Timeframe/Schedule:

Activity

- Conduct inception meeting with MEAL PM and Health PM to discuss and agree on the requirements for each of the outputs, with focus on the data analysis framework. Numbers of days: 1/2

- Revise survey and design methodology – analysis framework Number of days: 1/2

- Analyse data using suitable statistical analysis platform, ensuring accurate regression of specific indicators requiring complex analysis (including, but not limited to, those data requiring disaggregation by age, such as children aged 0-23 months and children aged 0-59 months, and pregnant and lactating women) using descriptive statistics and associated confidence interval. Number of days: 5

- Share the excel sheet for data validation including data analysis outputs Number of days: 1

- Share preliminary findings in a one-day online workshop with Medair Lebanon country office (MEAL, Health, and senior management team). Number of days: 1

- Prepare and share the draft report with country office. Number of days: 5

- Finalize the report including the feedback from Senior Health Advisor (GSO), Senior MEAL Advisor (GSO), regional MEAL Advisor, Health PM (country office), and MEAL PM (country office). Number of days: 2

- Outline Data to create infographic one-pager about the finding Number of days: 2

RESPONSIBILITIES

Consultant Responsabilities

Within the necessary timeframes:

• Submit proof of registration as Consultant to Medair before the starting date of the contract.
• Provide laptop, software, or any other relevant and necessary equipment for report writing and personal use (not chargeable to or reimbursable by Medair).

Medair Responsabilities

Medair is responsible for line management of all Medair employees. This responsibility cannot and will not be transferred to the Consultant. Medair is responsible for providing clean and validated data to the consultant at the commencement of the consultancy. Medair staff (focal point Alia Freidi) can be expected to be available within Lebanese working hours (9am-4pm, Monday – Friday) to provide answers which the consultant may require to complete the assigned task according to this Terms of Reference.

How to apply Consultancy fees and terms of payment

The consultancy fees payable to the Consultant will be in US dollars. The consultancy fees are based on the bid made by the successful candidate, and calculated on the basis of an estimated 16 days of work paid when the final version of the Consultant’s report has been finalised and approved by Medair.

Documents for interested applicants to submit

• Curriculum Vitae(s)
• Example(s) of similar work conducted
• An expression of interest, explaining how and why the applicant(s) are best suited to deliver on the work proposed
• A financial proposal

Application contact and deadline

The applications should be sent to procurement@medair.org

The deadline for applications is : Sunday 24th of September 2023

About the Organization

Medair

Medair is a humanitarian organisation inspired by Christian faith to relieve human suffering in some of the world’s most remote and devastated places. We bring relief and recovery to people in crisis, regardless of race, creed or nationality. As signatories of the Red Cross Code of Conduct, we believe that aid should be given to everyone who is in need, regardless of political, social or religious viewpoint. We save lives in emergencies and then stay to help people recover from crisis with dignity—working side by side with communities to leave a lasting impact. We provide a range of emergency relief and recovery services: health care and nutrition; safe water, sanitation, and hygiene; shelter and infrastructure.