SRHR Consultant

Terms of Reference

- SRHR consultant -

Baseline study (January – March 2023):

Background:

Oxfam in Lebanon and Marsa are implementing a 5-year, Global Affairs Canada (GAC) funded project entitled “Power to Choose – Sexual and Reproductive Health Rights for Young Women and Adolescent Girls”. Overall, the project aims to increase the enjoyment of health-related human rights by the most marginalized and vulnerable women and adolescent girls in the northern city of Tripoli. This goal will be achieved through (1) Increased agency of young women and adolescent girls contributing to their equitable use of sexual and reproductive health services, (2) improved provision of gender-responsive, inclusive and accountable sexual and reproductive health services by health care providers for diverse groups of young women and adolescent girls, and (3) improved effectiveness of key stakeholders, particularly women and youth organizations or movements, to advocate for evidence-based health care policies, accountable legal framework, equitable and inclusive services.

Oxfam in Lebanon is looking to hire a consultant to design and collect baseline data and inform the programming for the second pillar of the project (sexual and reproductive health services by health care service providers). The baseline study will target health care providers in the Tripoli area which needs to include three primary health care centres, a group of midwives, in addition to gynaecologists in the area who work in private clinics. The baseline study will also need to include two additional centres that Marsa will be operating in during the project period. The study should also incorporate the perceptions and experiences of individuals who benefit from sexual and reproductive health services at these centres. The baseline study will be used as a point of reference against which progress of outcomes will be measured and assessed to provide relevant quantitative and qualitative data on the project’s results indicators. It will also provide a starting point to capture health care providers’ SRH knowledge, beliefs, attitudes, behaviours, SRHR services provided and the extent to which those services are inclusive to different diverse groups. The findings will be used to inform the programming strategies used in the second pillar. At the end of the project, the methodology will be replicated to assess changes in results indicators over the project lifetime.

Objective of the consultancy

The baseline study will be focused on health care service providers located in the Tripoli area. Oxfam in Lebanon has already received approval from the Ministry of Public Health to conduct baseline assessments at the following Primary Health Care Centres (PHCCs) in Tripoli: Al Rahma PHCC in Abou Samra, Dahr Al Moghor PHCC and Makaram PHCC in Mina. The baseline assessment should also include a sample of midwives and a sample of gynaecologists who work in private clinics, in the Tripoli area. Two community centres/local actors, Sanabel el Nour and Ruwwad el Tanmiya need to also be included as Marsa will be providing SRHR services in them during project implementation. In terms of service users, the baseline study should cover the experiences they had when receiving SRHR services and their satisfaction with these services, particularly at the following four centres: Al Rahma PHCC, Dahr Al Moghor PHCC, Makarem PHCC and Sanabel el Nour.

With guidance from Oxfam and Marsa, the consultant will design and implement a baseline study including:

• Methodology development and validation
• Desk/literature review
• Data collection tools development
• Data collection, cleaning, and analyses
• Report write up

The baseline study should focus on the following aspects:

• General information about the facility and its SRHR resources
• Inclusivity of SRHR services provided (with a focus on adolescents, youth, boys and girls)
• SRHR technical training/ soft & technical capacity building needs of healthcare service providers
• Attitudes of healthcare service providers towards provision of SRHR services to youth
• Contraception methods and supplies available at the centres
• Knowledge of healthcare service providers on Sexual and Reproductive Health & Rights topics
• Availability of information education communication Materials (IEC) on SRHR services at the facilities
• Ability to detect GBV cases and respond to them
• Readiness to work with LGBTQ communities and other minorities & affected groups
• Satisfaction of service users with the SRHR services they receive at the health care centres

Oxfam in Lebanon will provide the consultant with a “Sexual and Reproductive Health Facility, Providers and Training Needs Assessment” tool which was built to cover  data needs on a human rights approach to family planning and emergency obstetric and neonatal care as well as GBV responsiveness in other countries as well. This tool has been developed by Oxfam Quebec in collaboration with the Society of Obstetricians and Gynecologists of Canada (SOGC). The consultant will be required to go over the tool, synthesize it, adapt it and separate it into different tools based on the information needs, the target group to be interviewed and also the Lebanese context. The consultant may be required to develop additional tools for key informant interviews.

The baseline study is also expected to collect baseline information for all the following result indicators in the project’s logical framework:

Objectives

Indicator

Improved provision of gender-responsive, inclusive and accountable sexual and reproductive health services by providers for diverse groups of YW & AG

1200.2 % (nb/total) of providers who have adopted practices that support inclusive SRHR for YW, AG and groups in situation of marginalization (disaggregated by location)

1200.4 # of visits[1] for family planning services[2]

1200.5 # of visits for sexual health services[3]

Improved health workers' and administrators’ knowledge, skills and attitudes related to the provision of quality, inclusive and judgment-free sexual and reproductive care

1210.1 Level of knowledge of health care workers or administrators on selected SRHR topics (disaggregated by gender and location)

1210.2 Degree of supportive and favourable attitudes of health workers towards gender equality and inclusive access to SHRH in their daily practice (disaggregated by gender and location)

Enhanced quality and quantity of SRHR services and health facilities for YW & AG

1220.2 % (nb/total) of primary service delivery points with at least 3 modern methods of contraception available on the day of assessment (disaggregated by location)

1220.3 Number of existing or newly designed environmental strategies ensuring ongoing application of national and/or international standards in biomedical waste management, WASH infrastructure, etc.

Expected Deliverables

Based on the above expectations the consultant is expected to provide the following deliverables:

• Written methodology (including sampling methods, ethical considerations, possible limitations)
• Data collection tools
• Cleaned database (qualitative, quantitative)
• Report with findings and recommendations (including consolidation/synthesis of the results from different sources)
• Final revised report - number of revisions depend on the quality of the submitted document
• Power Point Presentation of the findings

Baseline report (10-15 pages) must be comprised of the following sections:

• Executive summary
• Background and context of SRHR (policies, legal framework affecting the provision of SRHR services; etc.)
• Methodology:
  • How the data was collected, analysed, and validated (design study, sampling, protocols for data collection, criteria for disaggregation, criteria for selection of health care service providers, criteria for qualitative methods)
  • Including challenges and limitations that must be considered to understand and interpret findings

• Key findings:
  • Critical analysis of the collected data through statistical treatment and triangulation with other sources that include SRHR working groups and other needs assessments by the Ministry of Public Health

• Outstanding recommendations emerging from the analysis
  • Including recommendation(s)on topics that could be included in the upcoming training or support activities provided through this project to health care service providers and centres
  • Including recommendation(s)to address data limitations and gaps
  • Including new or emerging learning questions that should be taken forward-Including recommendations on how to monitor and assess progress towards transformational change.

• Annexes:
  • Power to Choose Pillar 2 Indicators Matrix completed (found in the “Sexual and Reproductive Health Facility, Providers and Training Needs Assessment” tool)
  • A copy of all tools, surveys and questionnaires used for data collection (qualitative or quantitative)
  • Data sets (original and cleaned) including any field notes

Timeline and expected number of days

The consultant is expected to provide the deliverables within a period of 25 working days that extends between January 16th and March 6th 2023 as per the below preliminary timeframe:

Key Deliverable                                                                                           Expected date of submission

Methodology and data collection tools                                                      January 23, 2023

Submission of first draft report                                                                   February 17, 2023

Submission of final draft and Powerpoint presentation                            March 6, 2023

The timeline above takes into account that Oxfam and Marsa will require at least 1 week to review the different deliverables shared.

Consultant qualifications:

This consultancy should be led by a person (or team) with:

• Prior experience working on research specific to sexual and reproductive health
• A minimum of 5 years of experience in conducting quantitative and qualitative research
• Knowledge of gender-sensitive and feminist approaches
• Excellent communications skills in English, including advanced writing skills
• Strong communication skills in Arabic are preferred
• Knowledge in technical medical processes and terms that relate to SRHR services is preferred
• Availability to start immediately

Payment and instructions for interested consultants

The payment will be made based on the budget in the offer (not based on actual expenses incurred by the consultant). No receipts will be requested from the consultant at the end of the contract.

CODES OF BEHAVIOUR:

The process will be directed by Oxfam’s guidelines for the ethical conduct of evaluations and research, guiding the team of consultants through careful consideration of the key ethical implications at every stage of the harvest. These guidelines are available at this link: http://policy-practice.oxfam.org.uk/publications/undertaking-research-with-ethics-253032

SHARING AND USING FINDINGS:

The final report will be shared internally with Oxfam staff and affiliates. It will also be shared externally with relevant actors and organizations. Generated data will be used to inform Oxfam’s programmes in Lebanon and may be used by Oxfam in publications.

DISCLOSURE:

Although free to discuss with the authorities on anything relevant to the assignment, under the terms of reference, the consultant is not authorized to make any commitments on behalf of Oxfam. All data collected as part of this consultancy belongs to Oxfam and public dissemination of the data and findings and recommendations can only be done with the written consent of the Oxfam.

[1] Visits are consultations or appointments. A person can receive more than one visit. For example, a woman sees a gynecologist to receive contraception on Monday and on Thursday she comes back for counseling, this counts as two visits.

[2] GAC defines family planning services as a range of long-acting reversible and short-acting contraceptive methods available at healthcare facilities based on demand, in a private and confidential setting Counselling emphasis informed choice and effectiveness. Emergency contraception services and follow up care.

[3] GAC defines sexual health services as testing for STBBIs, HPV vaccination, HIV testing, counselling emphasizes confidentiality, informed choice, and effectiveness