Consultancy for Technical Assistance (TA) – Initiative Endline Evaluation Study

Consultancies

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TERMS OF REFERENCE
Consultancy for the Technical Assistance (TA) Initiative Endline Evaluation Study
Terms of Reference (TOR) for services to support Technical Assistance Initiative end-line study

Duration : Over 1 month
Duty Station : Lilongwe, Malawi
Reports to : Head of Programs
Assignment end Date : July 2024

Who we are

Amref Health Africa the largest African-based, health development organization. With its headquarters in Nairobi, Kenya, the organization has a strong regional presence and is currently implementing more than 130 health programs in over 35 African countries. The organization has 10 implementing offices in Africa including Malawi. Amref Health Africa has recently transitioned to a new strategy (2023-2030) with a vision to bring about lasting health change in Africa. Our mission is to catalyze and drive community-led and people-cantered health systems while addressing social determinants of heath. Our strategies are to invest in people-cantered health systems for sustainable primary health care and to target social determinants and emerging threats at the intersection with health in order to increase equitable access. To achieve lasting health change, Amref Health Africa works with the most vulnerable African communities. Amref believes that the power to transform Africa’s health lies within its communities.

We work side by side with women and men in communities to build the knowledge, skills and means to transform their health, laying foundations that will be felt for generations to come.

1. Background
The Amref Health Africa (Amref) has been implementing a technical assistance initiative in Malawi from November 2022 to strengthen the capacity of the Community Health Department and planning department in the Malawi’s Ministry of Health to develop systems and mobilize resources for effective delivery of the National Community Health Framework (2023 –

2030) to improve Primary Health Care (PHC), and put in place systems for implementation of health financing reforms as set out in the Health Sector Strategic Plan III (2023-2030) and National Health Financing strategy, specifically, Direct Health Facility Financing and Strategic Purchasing.

The TA initiative had three key objectives:

  1. Contribute to the development of a robust, comprehensive and integrated community health information System (iCHIS) for data management and utilization by March, 2024
  2. Strengthen awareness, knowledge, expertise, and institutional capacity of government institutions on strategic purchasing for the delivery of high-quality care and advance universal health coverage (UHC) in Malawi.
  3. Contribute to the development and implementation of effective resource mobilization and fundraising strategies for the NCHF (2023-2030)

Initiative implementation ends in August 2024, and this end line evaluation is intended to be carried out between June and July 2024.

2. Objectives of End line study
The objectives of the baseline are as follows:

  1. To determine the effectiveness of the Technical Assistance (TA) models, which were utilized during the implementation period, document key lessons and why they worked or not.
  2. To assess iCHIS’ contribution to data utilization and decision making, if any.
  3. To determine levels of awareness, knowledge, expertise, and institutional capacity of government institutions on strategic purchasing for the delivery of high quality care for improved PHC to drive the UHC agenda.
  4. Provide evidence on the initiative’s contribution to the development and implementation of effective resource mobilization and fundraising strategies for the NCHF (2023 -2030)
  5. To identify and document intended outcomes, unintended outcomes, best practices, and lessons learned, as well as challenges experienced during TA initiative implementation.
  6. To assess the organizational capacity (in Amef Malawi) to conduct TA and the perception of TA recipients (the government) on Amrel’s TA

Evaluation Questions

  1. What is the effectiveness, efficiency, relevance, coherence and sustainability of TA initiative outcomes, approaches, models, principles and strategies?
  2. What is contribution of iCHIS on to data utilization and decision making, if any?
  3. What is the initiative’s contribution to the development and implementation of effective resource mobilization and fundraising strategies for the NCHF (2023 -2030).
  4. What are the outcomes (intended and unintended), best practices, lessons learned and challenges experienced during TA initiative implementation, and recommendations from the implementation lessons.
  5. Have the TA modalities and approaches deployed in this TA initiative effected sustainable and transformative change in Malawi?
  6. What are the critical success factors for TA in Malawi’s context? It is of interest for Amref to identify tested TA models and principles that have proven effective in the provision of tailored TA.
  7. How does Amef TA delivery generate a return on investment in Malawi?

Scope of work

The consultant and his/her team will be expected to undertake the following tasks:

  • Develop a proposal detailing the consultant’s understanding of the assignment, proposed methodology, deliverables, timelines and budget.
  • Develop data collection tools to be reviewed by Amref Malawi and Amref HQ.
  • Recruit Research Assistants to work with the consultant in managing primary and secondary data collection.
  • Conduct a desk review of TA initiative documentation and other relevant materials.
  • Develop a comprehensive implementation plan for carrying out the end line evaluation, including a training plan for the research assistants Train research assistants and pre-test data collection tools.
    Coordinate and supervise data collection and conduct data analysis.
    Prepare a draft technical evaluation report and share this with Amref Malawi and Amref HQ for feedback.
  • Present the evaluation findings to Amref Malawi and Amref HQ for discussion.
  • Conduct a dissemination meeting to share the evaluation findings and any recommendations with key stakeholders (including MoH).
  • Develop a final technical evaluation report incorporating all feedback provided.
  • Document the organizational capacity (in Amef Malawi) to conduct
    TA and the perception of TA recipients (Ministry of Health) on Amrefs Technical Assistance.
  • Develop a policy brief on Direct Facility Financing in collaboration with the Amref Malawi team.
  • Document a case study on the impact of iCHIS in decision making and action taken by community health workers at the point of care
  • Develop a report documenting the process and intel involved in co-creation and co-implementation towards actualizing the rollout of NCHS TA initiative, together with lessons learnt and key recommendations for the purposes of promoting Adaptation and Implementation across the region
  • Develop a manuscript and an impact story series for publishing the achievements of the TA initiative in Malawi
  • Submit to Amref Malawi the final technical evaluation report. The report should be no more than 40 pages long, excluding annexes.

3. Methodology

The end line will largely follow qualitative methods of assessment to guide processes from tools development, data collection, analysis and report writing. At a minimum, the end line evaluation will follow the DAC OECD criteria and assess the impact, effectiveness, efficiency, relevance, coherence and sustainability of TA initiative outcomes, approaches, models, principles and strategies.

The following data collection methods are proposed:

  1. Document review: The consultant to review the TA models and principles, and other project related documents including government policy documents – HSSPIII, Health Financing Strategy, Direct Facility Financing guidelines, national Community Health Financing Framework
  2. Key Informant interviews with relevant project leads, government officials at both national and district levels, and community health workers.

3.1 Data Analysis and Reporting
The evaluation interviews will be digitally recorded with consent from participants, transcribed, and translated wherever necessary.

The transcripts will be entered into an electronic qualitative data management and analysis software (Nvivo 11) for analysis. A deductive approach, which implies using pre-existing themes based on the TA conceptual and implementation framework will form a lead for the development of a coding framework. Transcripts will be coded and data will be further analyzed, ‘charted’ in themes and subthemes and summarized in narratives for each theme and subtheme including TA principles.

3.2 Deliverables
This following are the deliverables from the end line study:

  • An inception report with the relevant annexes (data collection tools/ guides), detailed implementation plan
  • Draft end line report
  • Virtual dissemination of the preliminary findings based on the draft report; for validation of the findings Final evaluation report Key learning products –
  • 1 Case study
  • 1 policy briefs
  • A report documenting the co-creation and co-implementation process and intel involved towards actualizing the roll-out of NCHS TA initiative, together with key lessons learnt and clear recommendation,
  • A manuscript and an impact story series for publishing the achievements of the TA initiative in Malawi
  • Raw datasets, codebook, recordings and transcripts

3.3 Qualifications of the Consultant
The Consultant shall have:

  • 7-10 years of experience in the development sector; experience in evaluations, research, assessments and identification of stakeholders to obtain contextual information. Specific experience in Evaluations focussed on TA processes and operations.
  • Experience in conducting evaluations following the OECD-DAC criteria (www.oecd.org/dac/evaluation/daccriteriaforevaluatingdevelopmentassistance.htm)
  • Expertise in health-related areas preferred
  • Excellent qualitative analysis and report writing skills;
  • Demonstrated experience in concisely reviewing and packing lessons learned, providing recommendations on how to apply those lessons.
  • Demonstrated past experience of doing similar kind of work
  • Demonstrated experience in concisely reviewing and packing lessons learned, providing recommendations on how to apply those lessons.
  • Demonstrated past experience of doing similar kind of work
  • A Masters’ Degree or its equivalent in any relevant health related field Those with a Master’s degree in health policy, health economics and/ or international development will have an added advantage.
  • Proven research, analytical, communication and report writing skills (Sample previous work(s) required during submission)
  • Demonstrated experience in writing manuscripts for publication

4. Budget and Timeline

  • Identify the resources required, including personnel, technology, and travel expenses, and give an estimated budget for the evaluation.
  • Present a detailed timeline for the entire evaluation process, including preparation, data collection, analysis, and reporting. In the timeline, include the number of days required to finalize the evaluation.

5. Remuneration
Amref Health Africa will pay a consultancy fee after successfully meeting the objective of the assignment and the deliverables. It is important to note that there will be a 20% withholding tax deduction from the total consultancy fee. The consultancy fee will be paid as follows: 40% upon submission of inception report and 60% upon successful completion of the assignment.

6. Confidentiality
All the information, documents, intelligence, findings from engagements and reports in this assignment shall be treated with the strictest confidence and remains the property of Amref Health Africa.

7. Submission of proposal
The technical and financial proposal should be submitted to tender.malawi@amref.org by the 21st of June, 2024. The financial proposal should be presented both in Malawi Kwacha and USD equivalent.

8. Evaluation and award of consultancy
Amref Health Africa will evaluate the proposals and award the assignment based on technical and financial feasibility. Amref reserves the right to accept or reject any proposal received without giving reasons and is not bound to accept the lowest or the highest bidder.

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