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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
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Study area
The survey will be conducted in Lascanood, Erigavo, Ceel afweyn, Badhan, Dhusamareeb, Cabudwaq,Kismayo, Dhobley and Afmadow Districts where CARE is implementing Sexual and reproductive health services integrated into health and nutrition projects.
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.
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.
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Consultant role and responsibility
- Develop and design study protocol and questionnaires, including
sample size estimation, population size, clustering of the villages and
validate contextual tools
- 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
- Train the KAP data collection teams and data clerks in data collection standards and use of the tools (including field testing)
- Implement the KAP survey in Sool, Sanaag, Bari, Galmudug and Lower Jubba
- Be responsible for data cleaning and analysis using appropriate software (i.e. Epi Info, SPSS, ENA for SMART, and ODK).
- Prepare a draft assessment report for review by CARE team ensuring
that the assessment is comprehensive and includes all relevant
indicators
- Prepare and lead a validation workshop (debriefing) for CARE and partners team
- 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.
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CARE’s role and responsibilities
- Facilitate logistic arrangement including travel, accommodation etc.
- Recruit Enumerators
- Mobilize the target groups for interviews
- Provide input to the inception report, tools and KAP draft report
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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
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Deliverables.
- Inception report that includes the design, implementation and
supervision strategy of the assessment including data collection tools
- COVID 19 adherence plan
- Data Collectors training power point
- First draft assessment report including raw data set in SPSS
- Submit power point presentation of key finding
- Final detailed report with recommendations with emphasis on among others on how;
- key barriers social and traditional barriers to gender and sexual health for women and Girls.
- Increased equitable use of health services by diverse groups of women and adolescent girls.
- Improved provision of gender-responsive, inclusive and accountable
health services by health care providers for diverse groups of women and
adolescent girls.
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Qualifications:
- Advanced degree in Reproductive health, Public Health, Nursing or related field
- At least 7 years of consulting experience at national or international levels in sexual and reproductive health assignments.
- Prior experience working on research specific to sexual and reproductive health
- Prior experience working with youth and women
- A minimum of 5 years of experience in conducting quantitative and qualitative research
- Knowledge of gender-sensitive approaches
- Excellent communications skills in English, including advanced writing skills
- Strong communication skills in Somali preferred
- Direct experience working with women and girls in diverse communities in Somalia
- Experience in qualitative research will be an added advantage
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Application Requirements.
The below requirements will be considered as part of the
selection process and therefore, all interested applicants are
encouraged to send.
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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.
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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).
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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.
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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.
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Duration of the Assignment.
- The duration of the assignment is 25 working days after signing of contract. Days are inclusive of traveTerms of Reference (TOR) for a study on barriers to gender and sexual health seeking behaviorslling, 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 14th September 2022.
Female applicants with requisite Somalia experience are highly encouraged.
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