USAID Empowered Communities Activity Baseline Assessment=-0

About Project HOPE

Project HOPE is a global health and humanitarian organization operating in more than 25 countries with the mission to place power in the hands of local health workers to save lives around the world. Founded in 1958, we work side-by-side with local health systems to improve health and support community resilience. We work at the epicenter of today’s greatest health challenges, including infectious and chronic diseases; disasters and health crises; maternal, neonatal and child health; pandemic preparedness and response; mental health for health workers; and the policies that impact how health care is delivered.

Background

Community Empowerment (CE) is a fundamental concept in the health sector that enables communities to define priorities, make informed choices, develop strategies, and execute them to improve health outcomes. It involves continual shifts in power relations between different individuals, social groups, and structures in society. In January 2024, USAID/Ethiopia awarded a four-year assistance activity entitled “USAID Empowered Communities” to Project HOPE, The People-to-People Health Foundation, Inc as a prime Implementing Partner. The goal of USAID Empowered Communities Activity (ECA) is to strengthen community platforms and systems to enhance Reproductive, Maternal, Newborn, Child, and Adolescent Health and Nutrition (RMNCAH-N) outcomes. To that end, improving community level health literacy and engagement, capacity strengthening of non-state actors (NSAs)[1] and accountability systems as well as increasing service delivery through Non-State Actors (NSAs) managed health facilities are important result areas. USAID ECA aims to address the social, cultural, political, and economic determinants that underpin health, and seeks to build partnerships with other sectors in finding solutions for better RMNCAH-N outcomes. USAID ECA technical approach strives to achieve a higher level of engagement whereby community members develop influence and take ownership in the decision-making processes that can improve their own health status. This relies on a multifaceted approach that integrates empirical evidence, established theories, targeted interventions, and participatory actions through various levels.

The Activity’s overall technical approach is underpinned by a modified Socio Ecological Model that offers a holistic perspective on health, recognizing the interactions between individual, interpersonal, community, and structural factors that are pertinent for community empowerment. By establishing processes by which communities can increase their control over their own health outcomes, USAID ECA will create an enabling environment for citizen engagement and advocacy that will enhance health and nutrition outcomes.

To achieve this, USAID ECA will implement the following major strategies and interventions: Enhance community ownership of health services by collaborating with USAID’s Health Behavior Activity (HBA) around evidence generation and health literacy interventions using community-owned and -based approaches; strengthen the advocacy capacities of NSAs to enhance the accountability, transparency, and responsiveness of the health system; strengthen accountability systems and platforms by mapping existing community structures, tapping into informal social networks, and introducing social accountability tools and platforms for improved feedback mechanisms; and increase delivery of quality RMNCAH-N services through local NSA health facilities by engaging in four strategic approaches (foundation, capacity strengthening, service delivery, and sustainability) to maximize NSA engagement and enhance program learning.

USAID-ECA has established a consortium of local and international organizations with the ideal capacity mix to successfully implement these strategies. JSI, Research & Training, Inc is the international sub-partner. In addition, the following are the eight local Implementing sub partners (LIPs): Family Guidance Association of Ethiopia (FGAE), Amhara Women Association (AWA), Mothers and Children Multisectoral Development Organization (MCMDO), Progynist, Professional Alliance for Development (PADet), Meseret Humanitarian Organization (MHO), Illu Women and Children Integrated Development Association (IWCIDA) and, Action for Integrated Sustainable Development Association (AISDA).

USAID ECA will strengthen the capacity (technical, administrative, and operational) of these consortium local implementing partners and community structures to implement this activity. USAID ECA will also explore and collaborate with resource partners and relevant networks and leverage their platforms (expertise/knowledge) to improve the visibility and contribution of NSAs to the health sector and women voice in delivery and accountability of RMNCAH-N services.

To ascertain the current state of community empowerment and engagement for RMNCAH-N services objectively, it is imperative to conduct a baseline assessment using representative samples of USAID ECA woredas and matching control woredas. The following describes the project's scope and the baseline assessment's indicative expectations. Therefore, within ten working days of this announcement, applicants who are interested in providing consulting services for the baseline survey are encouraged to apply.

USAID ECA Activity Implementation Scale/Geographic Coverage

The USAID-ECA will cover 40 districts in 5 regional states of Ethiopia. The districts/woreda distribution by region is listed Table 1.

Table 1: USAID ECA number and names of woredas by region, May 2024 

Region; Number of District/Woreda; Name of Woredas

1. Oromia;12 Districts; Alge Sachi, Ale, Metu, Tiro Afeta, Omo Nada, Sokoru, Fentale, Batu, Lome, Ameya, woliso and Dawo.
2. Amhara; 15 Districts; Farta, Fogera, Gondar Zuria, Kalu, Sayint, Kellala, Ambassel, Raya Kobo, Gidan, Debub Achefer, Yilmana Densa, Finoteselam, Guangua, Sekota Zuria & Gaz Gibla. 
3. Afar; 5 Districts; Chifra, Assayita, Dubti, Talalak and Dalifagie.
4. South Ethiopia; 4 Districts; Wonago, Dilla Zuria, Karta and Male.
5. Central Ethiopia; 4 Districts; Endiguagn, Enemor, Cheha and Shashogo. 

[1] If there are any change of woredas, ECA team will communicate the information with the winner

USAID ECA Results and outcomes (metrics)

USAID ECA has a comprehensive Monitoring, Evaluation, and Learning Plan that comprises lists of indicators and their definition, data source and collection procedures, reporting frequencies, and measurement approaches. This will be shared with the winner consulting firm for its reference in measuring the indicators.

List of outcome indicators to be measured are[3]:

• Percent of non-pregnant women aged 15-49 in a union/married using modern contraception
• Percent of women having early Antenatal Care visits during their most recent pregnancy
• Percent of women having at least four ANC visits during their most recent pregnancy in
• Percent of women whose recent delivery in the last four years assisted by skilled providers
• Percent of mothers receiving Postnatal Care (PNC) within 48 hours of birth for the most recent birth 
• Percent of children aged 12- 23 months that received Penta3 vaccines
• Percent/ number of pregnant women received iron-folic acid (at least 90 plus)
• Percent/number of adolescents and youth who received adolescent and youth friendly services.

Purpose of the baseline assessment

The primary objective of the baseline assessment is to provide current data (benchmark value) on key project indicators (quantitative and qualitative) before any actions are taken. This will help USAID ECA to assess the activity's performance during implementation and evaluate the impacts of the activity. The baseline assessment is also expected to improve our understanding on the context in which a project will operate, identify needs and priorities, inform revision of ECA's performance goals and objectives, inform resource planning, and ensure transparency and accountability to partners and stakeholders.

Objective of the Baseline assessment

The baseline assessment will provide concrete understanding of the existing community engagement and empowerment platforms and structures for health and nutrition:

• Establish baseline values for key (performance and outcome) indicators (quantitative and qualitative) of USAID ECA interventions, enable realistic target setting, and inform the refinement and/or streamlining of the proposed interventions, as necessary.
• Assess the health services, RMNCAH-N standards of care and rights literacy level at the community
• Assess the utilization of community-facility platforms for accountability, functionality of community structures, and implementation of full cycle community score card
• Assess capacity, visibility, and engagement status of Non-State Actors for accountability, responsiveness, and transparency of the health system
• Assess availability and quality of RMNCAH-N service delivery in Non-State Actor managed health facilities (e.g. FGAE clinics, private HFs et)
• Assess capacity of local implementing partners using a structured and standard capacity assessment tool[4]

Methodology

The baseline assessment will be conducted in the activity geographic areas described above. The baseline assessment will be expected to be completed in an eight-week period after the award. The consultancy firm is expected to suggest the best study design for this assessment considering the objectives listed under the objective section. The baseline assessment will employ both quantitative and qualitative data collection methodologies with comparison of matched non-intervention (control) woredas. Difference-in Differences analysis method will be used to capture the significant differences in outcomes across the intervention and control woerdas , which occur between pre-intervention and post-intervention periods analysis.

Some of the data collection methods includes but not limited to household surveys, key informant interviews with the activity partners, stakeholders, and beneficiaries, focus group discussions, secondary data abstraction, onsite observation, exit interviews, desk reviews and local implementing partner capacity assessment. The baseline assessment will also include service availability and readiness assessment (facility survey) for the Non-State Actors managed health facilities and health posts.

It is expected that the consulting firm will come up with a rigorous methodology to carry out the baseline assessment in accordance with the goals and objectives of the activity as well as the objectives of the survey. The design, the sampling unit/respondent, sample size and sampling procedure for each data collection method needs to be elaborated in the technical proposal[5].

Some of the assessment targets include local implementing partners, MOH structures at all levels including health facilities /health posts, community structures including client councils, development groups (women, men, adolescent, and youth), non-state actors/CSOs, NSA managed health facilities, clients at health facility and community, individuals in the project woredas. The consultants are expected to consider the unique context of the Afar region and South Omo Zone and propose a suitable approach to meet the assessment expectations

Timeline

The consulting firm should finalize the baseline assessment within 8 weeks following the signing of the agreement. The consultants should submit the detailed breakdown of the following major activities/milestones:

• Kick off meeting
• Development and submission of a work plan
• Finalize the design, sample size calculation, sampling techniques, sampling frames and analysis plans in consultation with the USAID ECA technical team.
• Prepare the baseline assessment instruments including household survey questionnaire, HF assessment tools, secondary data abstraction tools, LIP capacity assessment tools and qualitative data collection guides (KII, FGDs and Observation)
• Training for data collectors, supervisors, coordinators including field practice/pre-testing.
• Field data collection using a digital tool
• Data analysis and report writing.
• Presentation of key findings including timeline for feedback from USAID
• Preparation and submission of the first draft report.
• Incorporation of comments and finalization of the baseline report.    
• Final baseline results presentation

Major tasks /activities of the consulting firm

• Participate in briefing meetings on the assignment with USAID ECA team
• Review studies /other assessments done by other USAID activities like USAID Quality Health Care Activity, Low Land Health Activity, Healthy Behavior Activity, Community Nutrition Activity and Ethiopian Civic Engagement activity, and others, as needed.
• Submit inception report (protocol) that details the methodology and other key aspects of the survey including, but not limited to, the detail sample size calculation and sampling techniques, key indicators to measure, tool development process and schedule; study staff recruitment, training, and deployment plan; data collection logistics; data quality assurance plans; and data analysis plan. Moreover, it should also include proposed tools for data collection and proposed report outline and dummy tables.
• Meet with the USAID ECA team and USAID to discuss and address comments on the inception report and the other key deliverables.
• Develop the data collection tools in line with the project core outcome and impact indicators.
• Prepare baseline study protocol, submit, and secure IRB approval from relevant institution
• Recruit supervisors, enumerators, and local guides as per the plan detailed in the inception report.
• Train the survey team on the questionnaire and survey implementation using USAID ECA approved training materials.
• Oversee the quantitative and qualitative data collection process to include survey pre-test; and ensure effective management of data collection teams by supervisors. 
• Assure the data quality through proper supervision, questionnaire reviews, interview spot checks, daily discussion with data collection team on problems encountered and other data quality assurance methods detailed in the inception report
• Analyze quantitative and quantitative data using appropriate software programs
• Prepare and submit/present progress reports weekly
• Make a weekly/bi-weekly presentation to USAID on progress made and any challenges faced.
• Produce and submit to USAID ECA and USAID team draft report on findings (per required format and data request).
• Incorporate comments from the team into the draft report and produce the final report. 
• Finalize a high-quality baseline analysis report.
• Present findings to the USAID ECA and USAID team after the report submission 
• Coordinate with the USAID ECA team to disseminate study findings to stakeholders. 

Major Deliverables

• Survey inception report including proposed dummy tables.
• Reviewed and finalized household survey tools and checklists.
• Qualitative data collection tools and guides (KII, Observation, FGD etc…)
• Reviewed and finalized LIP capacity assessment tool
• A brief report of the field data collection process that outlines issues and challenges that may need to be considered in interpreting the final report within one week of completing the data collection.
• Key findings presentation
• Debriefing meeting with USAID ECA technical staff based on the field data collection process report mentioned above.
• Submission of preliminary findings within three weeks of field survey completion followed by briefing meeting with USAID ECA staff.
• Syntaxes generated for data cleaning, management, and analysis.
• Final cleaned datasets in STATA/SPSS.
• Transcripts of all qualitative data collected.
• Survey team name and contact details for regular check-in calls.
• Survey route plan, checklists prepared for the survey, data quality assessments tools in the field, data management manuals, datasets codebook and dictionary,
• Draft report for review based on the outline agreed in the inception report.
• Final report based on the outline agreed in the inception report. 
• Concise final and abridged report in three hard copies and soft copies.
• Power-point presentation for dissemination purposes.
• Present the survey findings at a national dissemination workshop organized by USAID ECA within one month of submitting the final report. 

[1] They include but not limited to civil society organizations (CSO), community-based organizations (CBO), faith-based organizations (FBO), other formal and informal community platforms, and private sector actors.

[2] If there are any change of woredas, ECA team will communicate the information with the winner

[3] This indicator list might change based on the changes in the activity LEM plan

[4] The capacity assessment tool to be used will be reviewed and approved by project ECA team and USAID

[5] The proposed baseline assessment methodology needs to be reviewed and approved by USAID before starting the baseline assessment

Study Team Composition and Qualification

Required qualification, experience, and composition of the proposed study team

The consultant firm should demonstrate expertise and experience in conducting comprehensive base line and research studies and have prior experience conducting similar work in Ethiopia. They should also have:

1. Technical team from multi-disciplinary backgrounds including higher level qualification in public health/epidemiology, monitoring and evaluation, social sciences, and related discipline with strong experience in quantitative and qualitative research.
2. Technical staff who are strongly familiar and knowledgeable with the national health system, including the Health Sector Transformation Plan, the Multi Sectoral Response Strategic Plans, the Health Extension Program Optimization Roadmap, social accountability and Non-state actors’ engagement in health. The key study team members should meet the below minimum criteria:

o  Lead investigator /team leader: will oversee the entire baseline assessment process and serve as the main point of contact with the USAID ECA. S/he should have a PhD in public health, social science, or a related field. S/he should have at least 10 years’ experience in leading similar assignment and experience in designing complex studies, report writing, manuscript writing and presentation

o   Statistician/analyst: S/he should have at least MSc in statistics or a related field. Have at least 8 years’ experience in conducting quantitative data analysis, preferably baseline, midterm or endline surveys. S/he will lead the survey design, sample size calculation, HH survey tool development, sampling procedure and data management including data analysis 

o  Qualitative researcher: S/he should have MSc degree in behavioural science. S/he will lead the qualitative section of the baseline assessment including refining the design, tool development, data collection and report writing. S/he should have experience in leading similar community projects in RMNCAH-N technical areas.

• The firm should have proven experience of carrying out large scale quantitative and qualitative studies focusing ideally on Community, RMNCAH-N and local capacity building of organizations and related issues.
• Proven experience/expertise on community engagement and empowerment
• Experience in conducting assessment on local capacity building projects (including the CSOs, Local private sectors and community structures capacities)
• Experience in organizational capacity assessment
• Capacity to work within a specified period to complete all the base line study activities and report to Project Hope as agreed.

Ethics, and Code of Conduct

• As the study team will be working on behalf of Project HOPE, they will be required to adhere to the ethical standards of the host country.
• Securing ethical clearance from a relevant body and support letters from relevant officials is require
•  The survey protocol and consent form will make clear to all participating stakeholders that they are under no obligation to participate in the survey and should obtain informed consent for their participation. All participants will be assured that there will be no negative consequences if they choose not to participate. Participants must be assured of the anonymity, confidentiality and protection of visual data and its use for agreed purpose only.
• Bidders are expected to implement sound and ethical judgement in their undertakings all through the procurement cycle. Misrepresentation of facts will not be tolerated.

Cost, Logistics, and mode of payment

The consulting firm will be responsible for arranging all the required logistics and related costs to conduct this assessment.

The consulting firm will be paid in three instalments:

• 1st installment: 35% upon submission and approval of inception report & data collection tools; and a signed contract
• 2nd installment: 35% upon submission of first draft report
• 3rd instalment 30 % upon submission and approval of final report and all agreed upon products of the survey

Evaluation criteria

Proposals will be evaluated by the selection committee based on the following criteria:

Technical Proposal (70%)

• Understanding of the scope of the project/TOR (10%)
• Quality and clarity of the technical approach methodology (30%)
• Profile of the proposed steady team (qualification, research expertise and related experience)-20%
• Evidence of demonstrated relevant experience undertaking similar work with contactable references (10%)

Financial Proposal (30%)

The financial proposal will be submitted during the proposal development stage and will be rated out of 30%. Shortlisted applicants will be invited to make presentations and have further discussions with the USAID ECA team before submitting a full proposal. 

Submission should include the following:

• Technical and financial proposals for conducting the exercise, with a clear interpretation of TOR,
• Team composition and time allocation, description of the methodology, breakdown of consultancy budget for the overall assignment in birr etc.
• A capability statement, including demonstrated ability to execute the assignment.
• Updated curriculum vitae of the consultant team; clearly spells out qualifications and experiences aligned to the tasks as outlined in the qualification section.
• Commitment that the consulting firm will be entirely engaged if consultancy is awarded.
• Attach work sample (baseline and evaluation reports) from at least two recent organizations where the services of the consultant/ team or firm have been utilized.

Application procedure and deadline

Consulting firms who meet or exceed the requirements should hand deliver their technical and financial proposals to Project HOPE Ethiopia, Addis Ababa, Minaye PLC Bldg., Kirkos Sub-City, Woreda 9, House # 501/004/498, between 8:00 AM and 5:30 PM from Monday to Thursday and 8:00AM to 1:30 PM on Friday not later than May 27,2024; at 5:00pm.

Any application submitted after the set deadline will not be considered.

Kindly note if you do not receive any communication from USAID ECA within one month after the close of the bid, consider your application is not successful. Only successful applicants will be contacted.