Health Project Evaluation In North Lebanon And Saida - Ein El Helweh

Terms of Reference: Health Project Evaluation in North Lebanon and Saida - Ein el Helweh June – July 2012   Project Title: Child and Maternal Health programme in Nahr el Bared, Beddawi and Ein el Helweh Palestinian refugee camps and surrounding gatherings About Medical Aid for Palestinians – MAP: Medical Aid for Palestinians (MAP) is a UK charity, established in 1984 in the aftermath of the Sabra and Shatila massacres, which provides support to the health and medical needs of the Palestinians living under occupation in Gaza and the West Bank, and to refugees in Lebanon and to other vulnerable communities in the region. MAP recognises that access to healthcare is the prime component of the fundamental human right to health. This right is compromised by military occupation, the ongoing conflict and the lack of a just political solution to the crisis. Working in partnership with local health providers and hospitals, MAP addresses a wide range of health issues and challenges faced by the Palestinian people. With offices located in Beirut, Ramallah and Gaza City, MAP responds rapidly in times of crisis, and works directly with communities in the longer term on health development. Project Background: To minimise the impact of current environmental living conditions on maternal and child health outcomes among displaced Palestinian refugees in Northern Camps in Lebanon, Medical Aid for Palestinians (MAP) has been implementing community outreach midwife services in Nahr el Bared and Beddawi since 2008. In 2010 the project was extended to Ein el Helweh camp and surrounding gatherings in Saida. A team of Nurses and Midwives focus on preventable determinants of poor outcomes and risk factors associated with pregnancy, childbirth, and child health; improving maternal health and reducing neonatal mortality and morbidity. The project focuses on the mother-to-child continuum of care and integrates a community ICMI approach (Integrated Management of Childhood Illness). In this latest phase of the project, social determinants of poor MCH outcomes, such as depression, gender violence & child abuse, were also targeted. MAP is working with local a local organisation, Developmental Action without Borders: Naba’a, to implement the community development aspects of this project. The work of the outreach midwives is supported by a Community Mothers element. The aim of this is to train women from within the community to be able to reinforce optimal health seeking behaviours and support the MCH outreach team. This includes parental support, delivering positive health information and reinforcing key messages. Objectives of the Current Phase: To reduce through targeted interventions, vulnerability indicators related to anaemia, unplanned pregnancies and infections, developmental delay in infants To address social determinants of poor MCH outcomes integrating a recognition of and response to domestic violence and child abuse into mainstream outreach program To consolidate the MCH outreach model and approach and ensure its future sustainability Target Beneficiaries: Vulnerable mothers and infants living in the Nahr el Bared, Beddawi and Ein el Helweh camps and surrounding gatherings. : -          Over 5000 mothers from the beginning of the project to date -          Over 3500 infants under 1 year of age The project’s active caseload is around: 2300 mothers and 1328 infants in the three regions.   Objective and Scope of the Evaluation: The overall purpose of the evaluation will be to inform the future development and implementation of MAP’s wider MCH programme to ensure that the intervention is effective, high quality, cost-effective and sustainable.   The evaluation will focus on seven key areas: 1.     Relevance of the project: From the perspective of the direct and indirect beneficiary groups, is this project a priority for the community? 2.     Effectiveness of the project: Which of the expected results have been achieved? Has the project made progress towards achieving its overall aim and have the expected results been achieved? 3.     Quality of project design: Were the activities which have been completed the most appropriate for achieving the overall aim and objectives? How well designed were the activities? To what extent has each element (midwives, community mothers, and reproductive health activities) contributed to the results achieved? 4.     Cost-effectiveness of the model: Could similar results be achieved with fewer resources? Could the project delivery model be adjusted to be more cost effective? 5.     Sustainability of results: Is sustainability without continued external support feasible? What could be done to improve sustainability of the results achieved at the technical, institutional and community levels? 6.     Evaluation of stakeholder relationships: An analysis of the partnership between MAP and Naba’a An analysis of the relationship between MAP, Naba’a and the beneficiary community An Analysis of the relationship between MAP and key stakeholders, especially UNRWA 7.     Recommendations: For the continuation and future development of the project   Methodology The exercise will entail a combination of: document analysis & desk review; discussion meetings with project management and field staff; consultations with partners, beneficiaries and key stakeholders. The evaluation should be participatory in nature and make use of focus groups.   Finalisation and Report Upon completion of the field visits, staff meetings and stakeholder consultations the final report should be prepared for submission to the donor by end of July 2012.