Technical consultancy to assess and design a behavioral change approach through RANAS methodology

Introduction/Programme Information

Project Title: Integrated Health and WASH to reduce COVID-19 impact in overcrowded settings - Phase II (IHWO - II).

Starting Date: 1st August 2021.   End date: 31 July 2022.

General Objective: Mitigate the impact and increase preparedness to reduce the spread of COVID-19 by enhancing preventive practices, facilitating isolation for positive or suspected cases and ensuring a holistic approach to addressing prevention in public schools and overcrowded settings.

Donor Agency: Bureau of Humanitarian Assistance (BHA).

Implementing NGO: Action Against Hunger (AAH).

Partners: Ministry of Education and Higher Education (MEHE), Civil Society Organizations.

Beneficiaries: Syrian and Lebanese students attending public schools and their caregivers.

Almost two years after the initial outbreak of COVID-19 in Lebanon, the total number of detected positive cases keep raising. Despite increasing the number of hospital beds, doctors, and nurses, the Health Sector has struggled to keep pace with the number of patients inundating medical facilities. Over the past months, the occupancy rate of intensive care unit beds has stagnated above 70% of capacity nationwide, with important discrepancies between regions – according to the World Health Organization (WHO) and the Ministry of Health (MoH).

The virus has continued to spread, particularly among vulnerable individuals in densely populated area, despite efforts from INGOs and movement restrictions imposed by the GoL in 2020 and 2021. The country has witnessed several waves of COVID-19, the latest being in January-February 2022 during which an average of 8,000 cases per day were reported.

The vaccination campaign was launched in Lebanon on February 14th 2021, and is expected to continue its roll-out until (at least) the end of 2022. Up until now, less than 40% of the population (aged over +12) has received the full dose.

In the Education Sector, the increased cost of education is preventing many children from returning to school. As private school tuition fees are fast becoming unaffordable for many families, the number of children attending public schools is set to continue increasing. This is adding pressure on an already stretched Lebanese public school system and contributing to reduce the number of Syrian and Palestinian refugee children who can enroll in second shift classes. In addition, the requirements of remote educational modalities are excluding those unable to afford technology or internet access this past two years. The increased cost of basic school items like textbooks, stationary, and IT equipment has also raised an additional barrier for many families.

Regarding COVID at school level, there are concerns from parents regarding infection prevention and control measures in schools, as the MEHE has not produced clear guidelines or provided adequate equipment. Indeed, trainings and PPE have not been delivered in sufficient quantities in anticipation of the reopening of schools according to the Education Sector. As a result, it is critical to disseminate awareness messages on COVID-19 regarding preventive measures and vaccination. It is also important to provide the means necessary to put recommendations in place, such sufficient quantities of safe water, proper sanitation facilities, and disinfection materials.

While there is insufficient evidence to measure the effect of school opening on the risk of COVID-19 transmission, the adverse effects of school closures on children’s safety, wellbeing and learning are well documented. Interrupting education services also has serious, long-term consequences for economies and societies such as increased inequality, poorer health outcomes, and reduced social cohesion.

Pandemic fatigue is setting-in as the situation becomes protracted. This is characterized by a loss of public trust in public authorities, lack of compliance with governmental restrictions, reduced perceptions of risk, negative psychological impacts, and a deteriorating socioeconomic situation for many households.

Objective of the Consultancy

If vulnerable populations have access to water, sanitation, and hygiene equipment and knowledge to behave properly from a hygiene perspective, the risks of COVID-19 will be mitigated in the forthcoming future in overcrowded settings. However, the theory behind this sentence needs an important clarification: to provide the right knowledge and information to the right-holders, we first need to understand what are the barriers, motivations and enablers that allow population to perform these particular hygiene practices that we are aiming to be reproduce.

Therefore, AAH is looking for a consultant who will propose a systematic approach to develop an evidence-based behavior change methodology, that will translate into operational campaigns at field level for Syrian and Lebanese children and their primary caregivers. The implementation of the campaigns will be led by AAH staff under BHA fund, focusing to achieve effective behavior change in handwashing with soap among children and their parents.

Particularly, AAH is looking to implement a behaviour change model, based on the Risk, Attitudes, Norms, Abilities, Self-Regulation at community level, also known as RANAS model. This model comprises the most important behavioural factors that influence the performance of health behaviours on a given community.

To develop an effective behaviour change strategy, AAH is looking for a consultant who will be able to develop and implement the following steps:

1)  A first phase where qualitative interviews are conducted with children and caretakers as well as other stakeholders to understand the context and potential motivators and barriers towards handwashing with soap.

2) A second phase, where children and their caregivers are interviewed about their handwashing practices, allowing the consultant to assess their behaviour with a quantitative survey. Additionally, the consultant should measure risks, perception, beliefs and attitudes related to handwashing with soap, but also social norms, ability, beliefs and self-regulation of both children and parents.

3) Based on the qualitative and quantitative assessments, the Consultant will identify which behavioural determinants are responsible for handwashing among children and caregivers. In this phase, the consultant should analyze and compare individuals that reported to wash their hands against those who reported not to do so (do/non-do analysis).

4) Based on that analysis, the behavioural factors that are identify as differently between doers and no-doers will be tackled with behaviour change techniques. Therefore, the consultant should provide which behaviour change techniques are matched to the behavioural factors in order to develop the next phase of the methodology.

5) The selected behaviour change techniques are translated into messages and activities for a coherent behaviour change campaign delivered at household or community level (to be decided). The campaign will target both children and parents, allowing children to act as agents of change in front of their caregivers and reinforcing the shared messages towards parents.

As a last step, the consultant will support on the implementation of the new strategy in collaboration with AAH teams in the field, making sure the designed strategy is integrated into the project’s activities and unfolded correctly.

Activities and Timeframe

Activities

Qualitative interviews

Development (Consultant) and implementation (AAH) of the qualitative research interviews with children and their parents. Timeframe: 15 days

Quantitative interviews

Development (Consultant) and implementation (AAH) of the quantitative research interviews with children and their parents. Timeframe: 30 days

Analyse and identify behavioural determinants

Identify which behavioural determinants are responsible for handwashing with soap among children and caregivers (Doers/Non-Doers analysis). Timeframe: 15 days

Identify behavioural change techniques

Selection of the behaviour change techniques and development of messages and activities accordingly. Timeframe: 10 days

Development of the campaign

Discussion of results in online workshops, development of detailed intervention manuals. Timeframe: 21 days

Support and monitoring the campaign

Campaign implementation by AAH with the support of the Consultant. Timeframe: 21 days

The proposed timeframe is just an estimation. The final time allocated for this consultancy will be linked to the delivery of the products mentioned below and the workplan approved by both the Consultant and AAH.

Role and Responsibility of the Contracting Party

Action Against Hunger agrees to:

• Provide on time all the necessary information and contacts for the accomplishment of the service.
• Review and validate the workplan, assessment templates and designed tools proposed by the Consultant.
• Review and validate all the reports and training/workshop materials proposed by the Consultant.
• Provide all the needed means in terms of staff and material to conduct the assessments, workshops, or the provision of needed information.
• Pay the Consultant according to the Terms of Payments agreed in the Contract.

Role and Responsibility of the Consultant

The Consultant agrees to:

• Develop and design the qualitative and quantitative tools to perform the research at field level.
• Monitor the quality of data collection. Correct if needed detected failures, informing AAH through email or an incident report.
• Respect the deadline established in the workplan and produce the outputs with maximum diligence and transparency, respecting the deadlines agreed with AAH.
• If needed, facilitate trainings and/or induction with AAH staff for the implementation of the qualitative and quantitative research.
• Commit to perform the consultancy as agreed with Action Against Hunger and not to change any stage work without the consent of Action Against Hunger.

Expected Deliverables

1. Development of both qualitative and quantitative interview templates to be implemented at field level with beneficiaries and stakeholders.  
2. Development of guidelines and training modules for AAH, to be able to perform the assessments at field level.
3. Provide an intermediary report detailing the results of the analysis (Doers vs No-Doers) and recommendations regarding the selected behaviour change techniques and the type of campaign to be implemented.
4. Development of campaign strategy, proposing detailed implementation manuals.
5. Final report detailing the analysis, the selected BCT, the campaign modality and the operational recommendations based on the context and the experience working with AAH team and the different stakeholders.

Consultant Requirements

Action Against Hunger is looking for a consultant with experience in behaviour change theory, specifically in RANAS methodology if possible, to design and implement the modality with the support of AAH staff. The consultant should have:

• Proven record on performing behaviour change research related to hygiene practices in a humanitarian context. Experience working in the MENA region is a plus.
• Proven experience in developing behaviour change modalities implemented at field level. Experience working with displaced populations, such as refugees or IDPs, is an asset.
• Good analysis capacity, extracting quick conclusions and recommendations from field assessments, workshops, and consultations with different stakeholders.
• Contextual knowledge of Lebanon and its current humanitarian situation is a plus.
• Capable of providing operational recommendations for future implementation of an expanded behaviour change approach within the Lebanese context.
• Good relational and communication skills, both in writing and verbally.
• Ability to work with different external & internal stakeholders.
• Advanced facilitation and training skills.
• Strong knowledge of English language.
• No pending judicial lawsuit that can endanger the objectives of the consultancy.

Application

Applicant should submit the following documentation:

1. Technical offer: includes methodology for conducting the model and developing the strategy including outline of the materials that fits the target group profile, time plan, consultant(s) CV and related documents prove her /his previous experience in implementing RANAS and similar consultancy services.
2. Price offer for the training, that must include:

• Price breakdown in United States Dollars
• The consultant(s) will cover logistical requirements for conducting the consultancy in Lebanon including international transportation, travel expenses, accommodation, and international insurance (with repatriation).

Evaluation of Applications

Application will be evaluated based on the following criteria: (i) profile and experience of the consultant about the related subject (25%), (ii) the methodology proposed for conducting the tasks (25%), and (iii) financial offer (50%).

Offers must be compliant with the Annex A: Good Business Regulations and Annex B: Purchase Terms and Conditions.

Submission of the offers

The deadline for submitting the quotation is March 4th, 2021, at 10:00 AM (Beirut Time) to be sent by email to Ms. Nancy Baassiry, Supply Chain Management Officer, email: procurement-bt@lb.acfspain.org.