Background
The Saving Newborn Lives program (SNL) of Save the Children, in collaboration with the Federal Ministry of Health (FMoH),regional health bureaus and zonal health departments; has been implementing demand creation strategy to improve service uptake to community based newborn care (CBNC) program. The Demand Creation Strategy for CBNC is based on local experiences that are proven feasible, effective, and scalable and it fits into the existing government’s Health Extension Program (HEP) and Health Development Army (HDA) platform. With the CBNC being the primary programmatic platform, the demand creation strategy addresses demand creation for the broader maternal newborn and child health services (MNCH).
The Community Based Newborn Care package was launched in 2013 by the FMOH with the goal of reducing newborn and child mortality through further strengthening of the Primary Health Care Unit (PHCU) approach. The comprehensive package includes:
Early identification of pregnancy, provision of focused antenatal care (ANC), Promotion of institutional delivery, Safe and clean delivery including provision of misoprostol in case of home deliveries or deliveries at health post level, Provision of immediate new-born care, including application of chlorhexidine on cord, Recognition of asphyxia, initial stimulation and resuscitation of newborn baby, Prevention and management of hypothermia, management of pre-term and/or low birth weight neonates and Management of neonatal sepsis/very-severe disease at community level.
CBNC seeks to achieve its goal by improving linkages between PHCUs and health posts, and the performance of health extension workers and Health Development Army (HDA). This in turn will improve antenatal, intrapartum, and newborn care through the “4Cs” (1) prenatal and postnatal Contact with the mother and newborn, including post-partum family planning; (2) Case-identification (Capture) of newborns with signs of possible severe bacterial infection; (3) Care, or treatment that is appropriate and (4) Completion of the treatment.
In order to achieve the goal of the CBNC Package, greater attention and understanding of care-seeking and community social norms and beliefs is required. Appropriate illnesses recognition and care seeking for newborn and childhood illness in Ethiopia is generally low and continues to drive high mortality rates.
The baseline results from the Integrated Community Case Management (ICCM) initiative in Oromia Region, indicated that amongst children who were sick with fever in the last two weeks before the survey, only 35.8% reported to receive any type of care while 23.4% reported to receive care from an appropriate service provider. Among children with symptom of acute respiratory infections (ARI), only 39.4% were taken to any health provider for treatment, while care from an appropriate health provider was only 28.1%. Only 27% of sick children with diarrhea sought care in the two weeks before the survey and only 16.4% were taken to an appropriate health service provider. Low levels of care seeking for common childhood illnesses, and lack of treatment of these illnesses with the appropriate drugs were noted. The study suggested the need to identify and address barriers to appropriate care seeking.
Assessment of ICCM Implementation Strength and Quality of Care in West Harerge and Jimma Zone of Oromia region also revealed low utilization of ICCM services. According to the study, intervention health posts had consulted, on average, one sick child in two days in the previous month before the survey.
When it comes to care seeking for newborns, the problem gets more pronounced. Multiple cultural attitudes and practices make care seeking for newborn more challenging. Local conceptions of newborn illnesses, inadequate recognition of danger signs, utilization of traditional therapy, and lack of financial resources, transportation and appropriate treatment constrain or delay utilization of health facilities for newborn illnesses.
Generally, despite availability of MNH services at health post level, different studies indicate that service utilization is very low. Although ICCM /CBNC is meant to increase access to care, uptake of community-based services is often disappointing. Demand creation activities and increased active case detection by HEWs are also urgently needed. Various studies have also recommended utilization of an effective community mobilization model as a means to address the low service uptake.
The purpose of the DC strategy for CBNC is to improve maternal and newborn outcomes through increased demand creation for CBNC. Objectives focus on increasing the uptake of appropriate MNCH behaviors, as promoted in the “4Cs” of FMOH CBNC Package, and the objectives are:
· To improve MNH related household practices and norms
· To increase timely care-seeking for maternal and newborn illnesses
· To create enabling social norms that support appropriate MNH behaviors
The evaluation will explore the extent to which the demand creation strategy resulted in changes in care seeking and household practices, and social norms.
ACTIVITIES TO BE UNDERTAKEN
Demand Creation Strategy’s evaluation Questionnaire’s translator, in coordination and combination with the SNL and external study team, will translate the survey tools into Amharic. The translator is expected to read systematically through the entire questionnaire so as to ensure all questions and explanations are captured correctly. The total number of pages to be translated and updated is about 20. There will be two rounds of translation: initial translation based on the final version of the English questionnaire before pre-testing, and possible second translation following possible revision of the questionnaire after the pre-testing. The translator will be responsible to:
• Review the Amharic questionnaires comparing it with the English version to check for consistency and completeness of the translated portions.
• Translate the any new upcoming additions /changes included into the English version to Amharic.
• Review and make necessary corrections to translation errors.
• Accommodate comments from the SNL team
• Accommodate any possible changes that may be made after the pre-testing, which is estimated up to total of 15 pages
SUPERVISION: The Amharic translator reports to SNL’s SBCC specialist
DELIVERABLES
· Initial translation: Electronic Amharic translation of the revisions /changes in the evaluation questionnaires within 5 working days from the date the questionnaire was provided, in power Ge’ez format.
· Second round translation: Electronic Amharic translation of the changes following pre-testing of the questionnaire within 2 working days from the date the questionnaire was provided, in power Ge’ez format.
DURATION OF CONTRACT: Eight days for the initial translation work as well as accommodate changes following pre-testing.
MINIMUM QULAIFICATION AND EXPERIENCE
To be considered for this position; applicants should have:
• Bachelor degree in a related field; understanding of health terminologies and research undertakings.
• It is important that the applicant have proven experience in surveys questionnaire translation• Fluency of Amharic and English language.
• Experience in translation of survey questionnaires with technical health terminologies.
• Experience in field survey activities.
• Experience in training of field data collectors.