Terms of Reference
Project title: Increasing Access to PPFP information and Services at Obstetric Centres within MSI Ethiopia
Project duration: August 2017 – April, 2018
Consultancy duration: March 30, 2018 – April 27, 2018
Type of contract: Part-time contract [Estimated level of effort: approximately 20 days]
1. Background
Marie Stopes International (MSI) operates in 38 countries worldwide to increase access to comprehensive sexual and reproductive health (SRH) services and to expand contraceptive choices for millions of women and couples. Operating for 40 years, MSI is a results-oriented social business which uses modern management and marketing techniques to provide family planning and safe abortion services. With the understanding that poor access to SRH services comes at a heavy cost to society, the organisation’s focus is on providing a full range of services to all people who need them, including the underserved and hard-to-reach, and at all points in the SRH service delivery continuum.
It is now widely known that offering modern contraception services as part of the care provided during childbirth can increase postpartum contraception use and is a key way to reduce unintended pregnancies and prevent pregnancies that are spaced too closely. However, opportunities to provide PPFP information and services are not currently fully understood or systematically leveraged. Evidence gaps exist relating to women’s preferences for when, how and from whom PPFP information and services are accessed, and provider perspectives on PPFP information and service integration are not well understood.
Many MSI and MSI-affiliated providers provide maternal and child health (MCH) services, including ante-natal care (ANC), post-natal care (PNC), child immunization and in some cases safe delivery. This is the case with MSI Ethiopia (MSIE), which operates 4 MCH centres. To help fill the gap in evidence around provision of PPFP, MSIE has designed and implemented an intervention within four of its MCH clinics, to strengthen the quality of the PPFP counselling and service provided to expecting and new mothers at various points in their care, and ultimately to increase uptake of PPFP services.
2. Objective and design of the Ethiopia PPFP pilot
The intention of this pilot is not to show the impact of a particular intervention since this has been done in previous research. Instead, it will pilot elements of PPFP interventions that have been shown to work, specifically: 1) training providers on PPFP client-centred counselling and PPFP service delivery, with a special focus on PPIUCD, 2) Induct all non-clinical staff on PPFP to enable them to gain familiarity with PPFP and be able to discuss its benefits with clients, 3) make use of MSIE’s existing SMS service by adding PPFP messages to the current messages sent to pregnant women, and 4) introduce provider motivation techniques, and 5) introduce supportive supervision for providers. The goal of these activities is to increase the likelihood that PPFP is discussed with mothers at all points of care in the MCH service delivery continuum.
The objectives of this intervention are to explore:
1. The feasibility of the intervention
2. Provider acceptability and preferences around PPFP service delivery
3. Changes to uptake of PPFP services
3. Purpose and description of the consultancy
A consultant is sought to help carry out data collection required to meet the second objective of this intervention. Specifically, a qualitative researcher is needed to conduct in-depth interviews with providers in order to help understand their experiences and preferences in delivering PPFP services generally and in the context of the intervention specifically. Interviews will also be conducted with the non-clinical staff members who were oriented on general PPFP principles and with the clinical supervisor providing supportive supervision to providers. The consultant will need to be someone local in Ethiopia.
The consultancy will require approximately 20 days in total. The consultant will work very closely with the MSI USAID team and with the project team in MSIE. The consultancy will begin in mid-to-end March, 2018 with the expectation for completion in mid-April. Some weeks will be built into the work plan and contract for contingency. A detailed timeline of activities is shown in section 4.
4. Specific activities, deliverables, level of effort, and timelines required of the consultant
The table below reflects specific deliverables required of this consultancy and the activities that are required in order to produce these deliverables. The estimated level of effort (LEO), in calendar days, required for each activity/ deliverable is also noted, along with the timeline or deadline.
Activity or deliverable | Estimated LEO (days) | Timeline | Deadline (for deliverable) |
Coordinate with MSIE on exact days for pilot test, visiting each clinic | 0.5 | 19-20 March, 2018 | N/A |
Meet with MSIE staff for one-day interview guidance and training; pilot testing of interview guides with non-participating MSIE clinic staff | 1 | 20 March, 2018 |
|
Conduct interview with clinical supervisor | 0.5 | 21 March, 2018 |
|
Travel to centre 1; with MSIE staff amend tools based on pilot test | 0.5 | 21 March, 2018 |
|
Conduct interviews with 2-3 providers and 1-2 non-clinical staff in Centre 1 | 2 | 22-23 March, 2018 |
|
Travel to clinic 2 | 0.5 | 24 March, 2018 |
|
Conduct interviews with 2-3 providers and 1-2 non-clinical staff in Clinic 2 | 2 | 26-27 March, 2018 |
|
Travel to clinic 3 | 0.5 | 27 March, 2018 |
|
Conduct interviews with 2-3 providers and 1-2 non-clinical staff in Clinic 3 | 2 | 28-29 March, 2018 |
|
Travel to clinic 4 | 0.5 | 29 March, 2018 |
|
Conduct interviews with 2-3 providers and 1-2 non-clinical staff in Clinic 4 | 2 | 30 March – 2 April, 2018 |
|
Interview recordings, transcribed notes, translations, and analysis due to MSIE | 5 | N/A | 6 April, 2018 |
Report summarising data collection activity and findings due to MSIE | 2 |
| 10 April, 2018 |
Contingency | 1 |
|
|
5. Key deliverables of the consultancy
The consultant will be required to produce the two deliverables listed in the table above- 1) tape recordings of interviews, transcribed notes (in English) and data analysis files and 2) a final report summarizing the data collection activity and findings from collected data. The deadlines indicated are tentative and may change. A revised deadline will be agreed in advance as per project timeline. The consultant will report to the Teshager Mersha (Research Advisor) within MSIE, and all deliverables should be submitted to her. There is an expectation for the consultant to provide constant feedback and communication with MSIE, to help address issues that arise and to keep MSIE abreast of emerging findings. In addition, after data collection has been completed from the first centre, the consultant will meet with the MSIE staff to provide feedback on the process and the study tools.
6. Consultant Travel
The Consultant is expected to travel locally across different regions where the MSIE headquarter office and the four MCH clinics are located, in order to carry out the required tasks. Depending on the consultant’s home base, the number of trips are expected to be 4-5, with 2-3 days at each location. The number and/or duration of trips may be adjusted and agreed based on further planning discussions with MSIE and/or based on refinement of the research methodology. There will be no international travel required as part of this consultancy.
7. Consultant payment
The consultant will be paid an agreed lump sum, for their service, at the very end of the consultancy, upon delivery and review of the final deliverable. Any other costs incurred during the study period (e.g., phone calls, travel to centres, and printing) will be reimbursed to the consultant at any time, as long as these are included in an invoice, receipts are submitted, and all costs are approved in advance by MSIE. While publication of the research findings in a peer-reviewed journal article is supported and encouraged, any costs incurred by the consultant in this effort will not be reimbursed by MSI because it is not a required deliverable.
8. Intellectual property rights
The consultant assigns all existing and future Intellectual Property Rights to Marie Stopes International Ethiopia, in all records, reports, documents, papers, drawings, designs, transparencies, photos, graphics, logos, typographical arrangements, software programs, inventions, ideas, discoveries, developments, improvements or innovations and all materials embodying them in whatever form, including but not limited to hard copy and electronic form, prepared by the consultant in connection with the provision of the Scope of Work and any invention, idea, discovery, development, improvement or innovation made by Marie Stopes International Ethiopia or the consultant in connection with the provision of the Scope of Work, whether or not patentable or capable of registration, and whether or not recorded in any medium and of all materials embodying such rights (the “Inventions”) and a written irrevocable waiver of all the consultant's statutory moral rights in the Works, to the fullest extent permissible by law.
1. Consultant requirements
This consultation requires a single individual with expertise in qualitative research. The consultant should have a proven track record of undertaking qualitative research in the field. Previous experience of carrying out data collection in a health service delivery context is highly desirable, and experience in the family planning sector specifically is a plus. Fluency in the local language is a requirement for all applicants. The consultant should at least:
The individual will preferably have experience in handling sensitive material and information, in conducting interviews concerning potentially sensitive issues, and in working within Ethiopia. Excellent written and verbal communications skills in English is highly desired.
2. Submission content
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