Save the Children has been working in Nigeria since 2001 and is a strong, recognised and respected voice for children’s rights. We work closely with the Nigerian national and local governments in order to develop sustainable, replicable and scalable projects that bring lasting change to children’s lives and help them to reach their potential. We are currently implementing some of the most innovative and large-scale health programmes in the country. Our program reaches millions of beneficiaries directly and indirectly yearly, through multi thematic programs (Child Protection, Child Poverty, Education, Health (WASH) & Nutrition). The country portfolio comprises of both development and humanitarian projects. Expansions in Child Protection and Nutrition programs has increased our geographical footprints to 11 states.
Context within which the HCB Project is Situated
Nigeria is the most populous country in Africa, with an estimated population of 170 million. The country is reputed to accounts for nearly one-quarter of the continent’s maternal and newborn deaths. Despite investments made in maternal and child health services, Nigeria has the ninth worst child mortality rate in the world. One out of every eight children born in Nigeria will not reach their fifth birthday, often as a result of common and easily preventable diseases such as malaria, pneumonia and diarrhea. Poor health outcomes for newborn babies and children under five in Nigeria are due largely to weaknesses in the supply and quality of health services delivered, as a result of limited human resources, a lack of lifesaving commodities and equipment, and inadequate infrastructure.
In 2016, Multiple Indicator Cluster Survey (MICS) reported that 43% of women had access to skilled birth attendants in Nigeria compared with the 38% reported in 2013 by NDHS. This was a 5% increase on what was reported in 2013, although by a different study. Similarly, Neonatal mortality rate in 2013 was 37% but did not really change significantly in 2017. This submission was inferred from the MICS study that reported mortality among newborn as 39% in 2016, an increase of 2%. The same can also be said of mortality among infants where the difference between NDHS 2013 reported figure of 69% was not significantly different from the 70% reported in 2016 by MICS. While the Government of Nigeria has articulated policies and plans to tackle the problem of morbidity and mortality among children and mothers, the health indices of mothers and children are improving nationally but very slowly.
Critical shortages in Human Resources for Health (HRH) pose a significant challenge to the effectiveness of the Nigerian health system. The Nigerian health system relies heavily on Community Health Workers, including Community Health Extension Workers (CHEWs) and Junior Community Health Extension Workers (JCHEWs), who man over two thirds of Primary Health Centres (PHCs) in Nigeria but often lack the necessary skills for delivery of quality healthcare. To create real change for women and children, the HCB project is delivering series of intervention that places access to quality services at the centre through improved capacity of the health workers. Specifically, Save the Children with funding from GSK is providing improved access to lifesaving healthcare, by directly building the capacity of 5,000 frontline health workers in Gombe, Kaduna and Lagos states.
Project Background, Objectives and Beneficiaries
Since June 2015, Save the Children with funding from Glaxo SmithKline (GSK) has been implementing a Health Workers Capacity Building (HCB) project (hereafter referred to as the project) in Gombe, Kaduna and Lagos states.
The project aims to contribute towards an overall goal of reducing maternal, newborn and child mortality (MNCH) rates in Lagos, Gombe and Kaduna states by training 5000 frontline health workers (Doctors, Nurses/Midwives and Community Health Extension Workers) to deliver quality MNCH services to women, families and communities in these states.
The project has two main objectives
Status and description of the HCB Project
Presently, the project is in its 3rd and final year of implementation and is scheduled to close out at the end of November 2018. Thus far, a total of 4736 health workers have been trained across the 3 focal states using nationally approved training manuals/guidelines. Furthermore, the project is estimated to have reached 489,751 beneficiaries indirectly (women and children under five).
Key training areas are Integrated Management of Childhood Illnesses (IMCI), Integrated Community Case Management of Common Childhood illnesses (ICCM), Essential Newborn Care Course (ENCC), Active Management of the third stage of labour (AMTSL), New Vaccine Administration (NVA), Essential Management of Vaccine services, Adverse Events following Immunization (AEFI), Routine Immunization Service delivery/Reaching Every Ward (RI/REW) and Basic guide on routine Immunization (BGRISP).
Beneficiaries of each of these training were selected through a series of training needs assessment that were jointly conducted by the project technical officers and relevant officials of the State Primary Health Care Development Agency (SPHCDA)/State Ministry of Health (SMOH) in each of the aforementioned states.
Additionally, in each of its focal states, the project is contributing to the creation of an enabling policy environment for the delivery of quality MNCH services by supporting the rollout of relevant national HRH policies and strategic plans; raising awareness amongst policy makers and stakeholders for improvements in health workforce planning, management and development; and leading multi-sectoral advocacy efforts for the allocation and timely release of adequate financial resources to the health system required to attract and retain qualified health workers.
Key interventions conducted in this regard include domestication/adaptation of National HRH policies and strategic plans, domestication/adaptation of national Task Shifting/Task Sharing (TSTS) policy, development of a training of trainers curriculum to facilitate the implementation of TSTS policy in each of the focal states, support for the establishment of functional HRH desks and development of advocacy tools such as policy, briefs, fact sheets, IEC materials and position papers.
Scope of the Endline Evaluation
In line with international best practice, a rigorous endline evaluation of the project will be carried out to determine its effectiveness, successes and challenges. The primary aim of this endline study is to evaluate the model of working as well to compare health worker knowledge in comparison to baseline. The primary input into the endline evaluation is high-quality, reliable, and consistent data collected from a number of sources across the areas of implementation. These data will be collected from the following group of persons who are either direct or indirect beneficiaries of the project: Doctors, Nurses/Midwives, CHEWs, In-charges of primary health facilities, Community Oriented Resource Persons (CORPs), Focal Persons for Health Programs at LGA, SMOH and SPHCDA levels and Pregnant Women and their Households. Respondents will also include relevant government officials at state and LGA levels. Sample sizes will be determined in consultation with the project’s technical leads.
The objectives of the evaluation are to:
Specifically, the endline evaluation will seek to determine:
Overall, attention must be given to:
The successful Consultant will deliver high-quality data according to the expectations and within a timeframe agreed to with Save the Children. The selected Consultant will work closely with the Project technical leads in each of the focal states and in particular with the project’s M&E officer during all phases of the evaluation. SCI may be open to considering electronic data collection using tablets or androids phones for this evaluation, and interested consultants should consider this when preparing their proposals. However, the list of tasks below assumes paper-based data collection.
The selected consultant(s) will:
Evaluation Design and Methodology
Interested consultants are expected to send in a detailed proposal that clearly articulates the following:
The methodology will be expected to use an appropriate combination of primary and secondary data and an adequate mix of quantitative and qualitative research methods.
In particular the following research methods are expected to be considered by the consultant
All work must be completed by the end of November 2018.
Terms and Conditions
a. Structure of Contract
The consultant(s) will be under contract with Save the Children Nigeria. Selection will be made on the basis of proposal quality and cost. Prior to signature of the final contract, all terms and conditions in this TOR are subject to modification.
Consultant(s) are requested to structure their proposals so that activity and cost is clearly delineated. Failure to do so will result in disqualification of the proposal.
The Consultant(s) will be responsible for delivering high-quality data according to the expectation and protocols of Save the Children Nigeria. The Consultant(s) will deliver data within the agreed upon timeline. The consultant(s) is required to submit all documentation related to the evaluation, including analytic files related to sampling, data files related to sampling, and documentation related to successful and high quality data collection (such as final data collection instruments, field manuals, training materials, and data entry program).
All data and information collected will belong to SCI The consultant(s) may not use the data for his/her own purposes, nor license the data to be used by others, without the written consent of Save the Children.
Submission of Expression of Interest
Candidates are expected to submit:
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Due to the volume of applications received, Save the Children may not provide feedback to all applicants. Only shortlisted candidates will be contacted.
Qualified candidates are encouraged to apply as soon as possible, as applications will be reviewed as received. Save the Children reserves the right to change the closing date, if considered necessary.