Quality of Care for Mothers and Babies Consultants at Save the Children Nigeria

Save the Children is a leading international organization helping children in need around the world. First established in the UK in 1919, separate national organizations have been set up in more than twenty-eight countries, sharing the aim of improving the lives of children through education, health care and economic opportunities, as well as emergency aid in cases of natural disasters, war and conflict.

In Nigeria, Save the Children has been working since 2001. The early focus was on getting children actively involved in shaping the decisions that affect their lives. Today, Save the Children is working in seven federal states - Zamfara, Yobe, Jigawa, Katsina, Kano, Bauchi and Kaduna - focusing on providing basic healthcare and protecting children.

We are recruiting to fill the position of:

Job Title: Quality of Care for Mothers and Babies Consultant

Job ID: #1118886
Locations: Jigawa and Lagos

Background and Introduction

• Save the Children in partnership with Unilever committed to make a real difference in the lives of women and newborn babies in Nigeria; by giving mothers the care they need, and babies the right start to a healthy life; one that they deserve. Through Unilever's support over three years, Save the Children planned to improve the lives and health status of an estimated 435,000 mothers and their babies; 112,000 mothers and babies in 13 Health facilities across 6 LGAs in Jigawa state , and 323,000 mothers and babies in 27 facilities in 7 LGAs and LCDAs in Lagos state. The project also committed to build the capacity of 1,000 health care workers to provide quality health services and appropriate care to mothers and their babies as well as increased awareness among mothers and access to quality maternal and newborn health services.
• The Quality of Care project was designed and implemented by following an integrated approach; involving Ward Development Committee (WDCs), supporting target Primary Healthcare Centers as agreed with SMoHs to implement multiple advocacy strategies addressing MNH issues at their ward.. This approach was adopted to maximize local stakeholders' involvement, contribution towards implementation of cost effective packages of proven MNH interventions along the continuum of care.

Purpose of the evaluation study:

• This summative evaluation is commissioned by the Quality of Care project team of Save the Children. The purpose of this evaluation is to assess both the processes and outcomes of the project, collect robust evidence, document lessons learnt and best practices to inform future planning, strategy and practice of Save the Children, leadership of SMoH and other relevant bodies.
• To this end Save the Children plans to present the findings of the evaluation in a dissemination workshop for major stakeholders including local government decision makers and feed into future strategy particularly as it relates to scle up of QoC approach in the 2 states and in Nigeria as a whole.

Specific Objectives
More specifically, this evaluation will explore the following key evaluation questions and develop recommendations based on the findings:

• To what extent did the project meet its stated objectives (Goal and Outcomes indicators) and demonstrated the effectiveness of the approach of Quality of Care contributing to improved health for mothers and newborn babies and technical strengths of the programme overall?
• Document project achievements and lessons learned as well as best practices and identify underlying factors (i.e. what worked well and why and what did not work and why).
• A comprehensive assessment of the effectiveness of the pilot post natal home visits using CHEWS to provide services to beneficiaries in their homes.
• Recommend improvements for the longer-term strategies on QoC focusing on project management, achieving quality, accountability and to replicate similar approach in other states in Nigeria. What should have been done differently to achieve more effectiveness, efficiency, Sustainability and impact?

Evaluation Criteria:

• Following evaluation criteria is based on the OECD-DAC principles for evaluation of development assistance; the following questions will be used to undertake the evaluation study. Final evaluation report will be expected to respond all questions mentioned below.

Relevance:

• To what extent were the objectives of the Quality of Care project valid in response to the needs of the community in the project target areas?
• Were the planned programme activities and outputs consistent with the progress on overall goal and objectives?
• Were the planned programme activities and outputs consistent with the intended impacts and effects on the improved healthcare for mothers and babies at the time of birth & Immediate Post-Partum Period?

Effectiveness:

• To what extent were the objectives achieved likely to be achieved by the end of the project and also identify the underlying reasons leading to achievements and key bottlenecks that contributed to delays?
• To what extent did the quality of care project cause changes to the practices of health workers and women that are known to reduce neonatal and maternal mortality? What factors were responsible for these changes?
• How effective was the advocacy strategy to influence the MoH's decision to step up regulations for the private sector, what is the evidence to demonstrate project contribution?
• How effective was the use of text messaging to convey key educational messages on maternal and newborn health?
• What was the effect generated by incorporating reflective practice into supportive supervision of health facilities?
• How effective was project activities to improve HMIS data quality and analysis?
• How effectively were the findings of the various studies (including Barrier to scaling up MNH interventions , Referral Study, Facility Assessment, Community Based Study of Neonatal Mortality in Lagos, and the report of the ongoing pilot for provision of postnatal home visits) been utilized and disseminated for influencing policies and practices at different levels of decision making?
• What have been the effect and the challenges of the pilot for community health worker postnatal home visits for mothers and newborns?
• How well did the project team engage with different stakeholders and partner organisations in order to achieve effectiveness and sustainability of project activities.

Efficiency:

• How efficient was the project in achieving the desired project outcomes.
• Were project objectives and activities achieved on time in the Quality of care Project?
• Have the most efficient approach/(es) been used to achieve project Outcomes and Outputs (as compared to alternatives approaches)?

Impact:

• What real difference has implementation of the project activities made in the lives of the beneficiaries?
• What were the key lasting changes achieved by the Quality of Care project particularly for Mothers and Babies at the Time of Birth & Immediate Post-Partum Period
• Did the training of health workers lead to changes in practice and improvement in the quality of care they provided, what evidence do we have and what evidence can we gather to demonstrate this?

Coherence:

• To what extent have our interventions been coordinated with the efforts of different stakeholders including WDCs/CDCc?
• What internal coordination problems did project team face and how was it addressed?
• What was the project level biggest achievement to demonstrate effective coordination? How can we improve coordination if Quality of Care project mobilize further resources?

Sustainability:

• To what extent will the benefits of the Quality of Care project for beneficiaries continue after the project funding ceases?
• To what extent will the government stakeholders be able to continue with implementation of the project activities in Lagos and Jigawa and do they have the funding and resources or other partners to enable continuity of activities.

Methodology:

• The lead consultant will develop the evaluation methodology in collaboration with the MNH Advisors for Lagos & Jigawa State the MEAL Advisor and MNH and M and E advisors from SCUK.
• The lead evaluator or team will be expected to write an inception report following review of existing literature and gaps where they explicitly propose an evaluation methodology.
• Such a methodology should define an appropriate sample size and specify mechanisms that will be adopted to avoid selection bias.
• The evaluation should meet the principles of participation of involving children and adults and making sure that men and women are representative in the data collection.

As a minimum, the evaluation process will include the following key steps:

• Secondary data review: Review of relevant literature related to the Quality of Care Project, this includes; the baseline health facility assessment report, project annual reports, project inception report, project monitoring data Barrier Analysis, Referral Study, Facility Assessment, Community Based Study of Neonatal Mortality in Lagos, and the report of the ongoing pilot for provision of postnatal home visits
• Draft inception report with summary of literature review and detailed evaluation study design including application of appropriate data collection tools (e.g. questionnaire, checklist etc) for Interviews and discussions with stakeholders including Save the Children staff. Field Data Collection by using -Quantitative and Qualitative methods will be used (Including FGDs and KIIs) with appropriate groups/individuals including beneficiaries, health workers, WDC/CDC members, policy makers and government officials at LGA and State level.
• Health Facility Assessment using similar research methodology as baseline assessment including observation of service provision in health facilities, assessments of equipment, commodities and infrastructure.
• To review the current status of MNCH related policies and strategies as outlined in the project log frame, as compared to their status at the inception of the project e.g. Child Health Policy and the IMNCH strategy.
• To ensure that all outcome indicators in the project log frame are assessed.

Expected Deliverables and Completion Dates

• Evaluation Study will be conducted between July 10, 2015 - 15 August 2015
• Key Activities Completion Date Planning meeting between consultant and SCI staff to review relevant documents and logistics arrangements for the evaluation.
• 2 Days Desk Review : Review of documentation and elaboration of field Study 3 Days Inception Report 3 Days Field activities in Lagos & Jigawa State 10days Analysis results, submit first draft of report 5days Final report, debrief and final presentation. 4days

The evaluation will follow the key phases
Phase 1- Desk study: Review of documentation and elaboration of field Study [3day]:

• The lead consultant/evaluation team will review relevant documentation. Based on this review; they will produce an inception report which will include an elaborate plan, methodology and sampling strategy of the data collection for evaluation study. The evaluation will only proceed to the next stage upon approval of this inception report. An appropriate inception report format will be made available to the team as part of this TOR.

Phase II: Field Data Collection [7-10 days]:

• This phase of the evaluation will seek to collect primary data on the key evaluation questions explained under evaluation criteria. The team will use the agreed plan, methodology and sampling strategy from phase 1 to conduct the field work.

Phase III - Data analysis and production of draft evaluation report [5days]:

• The team will draw out key issues in relation to evaluation questions and produce a comprehensive report.

Output and Deliverables
The following specific outputs are expected:

• An Inception report
• A draft evaluation report
• A Final draft evaluation report including country case studies and recommendations to Save the Children for future use of the same or alternative solutions to achieve the objectives.
• Data sets (SPSS, Excel) - for all collected data (quantitative and qualitative). Qualitative data should be transcribed for future use by Save the Children Country Program. The data sets should be in an appropriate format (SPSS, Excel, and Word) and will be submitted together with the final evaluation report
• PowerPoint presentation, summarizing the key findings from the evaluation submitted together with the final evaluation report

Inception Report:

• The evaluation team is expected to submit an inception report after 3 working days of commencing this evaluation.
• The purpose of this report is to detail the appropriateness and robust methodology to be employed.
• The inception report provides the organization and the evaluators with an opportunity to verify that they share the same understanding about the evaluation and clarify any misunderstanding at the outset.
• The report should reflect the team's review of literature and the gaps that the field work will fill. Field work will only commence once this report has been reviewed and agreed with the designated representatives (consortium) of the Stakeholders.

Draft Report:

• The draft evaluation report must be submitted to the MEAL Advisor and QoC team no later than eleven days (11) after the field study. The report should conform to a reporting format which will be made available to the consultant on signing the contract.

Final Report:

• The final report of the evaluation on the suggested format, after integration of the various comment made, must be submitted by the second week after draft report is submitted and feedback received.
• The evaluation report is an exclusive property of the Save the Children should not be released without prior authorization.
• The final report will be available through Save the Children and will also be circulated to the country Program.

Date Sets:

• The evaluation team will be expected to submit complete data sets (in SPSS/Access/ Excel) of all the quantitative data as well as the original transcribed qualitative data gathered during the exercise.
• These data sets should be provided at the time of submission of the final report

Summary Findings:

• On submission of the final report, the team is expected to submit a PowerPoint presentation (maximum 12 slides), summarizing the methodology, challenges faced, key findings under each of the evaluation criteria and main recommendations.

Suggested Report Format:

• Detailed guidelines on how to structure the evaluation report will be provided to the evaluation team prior to commencement of the activity. The team should conform to this format

Person Specification
Essential:

• A lead expert in the field of maternal and newborn health, and research in Nigeria.
• Demonstrate competency in maternal and newborn health programming.
• A minimum of 10 years' experience in administering surveys, conducting qualitative and quantitative analysis, collecting data and producing quality baseline and end line reports preferably for international non-profit organizations.
• Minimum education: Higher degrees in social sciences, public health, statistics or epidemiology.
• Knowledge of mixed methods design.
• Strong qualitative data analysis expertise required.
• Demonstrated analytical, communication and report-writing skills.

Administrative/Logistical Support
Budget:

• The lead evaluator will be expected to submit the estimated budget including their consultancy fees along with EoI form.

Application Closing Date
16th August, 2015

How to Apply
Interested and qualified candidates should send their C.V and qualifying statements to: [email protected] explaining why you are suitable for the position you are applying for. State position clearly in the subject field as applications without appropriate subject will be disqualified.

Note: Also, applications received after the above closing date will not be considered.