1. BACKGROUND AND CONTEXT ANALYSIS
Save the Children is the world leading independent non-profit organization for children. In Ethiopia, it operates across all regions with a vision of creating a world in which every child attains the right to survival, protection, and education. Its mission is to inspire breakthroughs in the way the world treats children, and to achieve immediate and lasting changes in their lives.
Save the Children is currently implementing programs in the thematic areas of Health, Nutrition, Child Protection, Education, Humanitarian, Disaster Risk Reduction. Save the Children’s health and nutrition programs seek to facilitate and promote sustained improvements in the health and nutritional status of children and women, with special attention given to the needs of vulnerable children and youth. In partnership with various government and civil society organizations, Save the Children works to ensure that youth, children, their mothers and other caregivers have access to and use key health and nutrition services, and adopt healthy behaviors.
Promoting Sexual and Reproductive Health and Family planning (SRH-FP) project is one of the few SRH projects being implemented by Save the Children under the Health and Nutrition thematic sector.
The project was funded by the European Union and it has been implemented in Afar and Amhara Regions of Ethiopia in total twenty Woredas, and of these five woredas are in North Wollo Zone (Kobo, Habru, Meket, Gidan, and Gubalafto), seven in South Wollo Zone (Kutaber, Albuko, Legeida, kelela, Jamma, Kalu and Tewledere), four in Waghimra Zone (Sekota Zuria, Gazgibela, Abergelie, and Dehana), and four Woredas in Afar regional state (Chifra, Ewa, Adhar, and Yallo). The project has been operational since February 2015 and will come to end in June 2019. It was implemented in partnership with a local NGOs known as African Network for the Planned and Program for Vulnerable Children And in Need (ANPPCAN).
The overall objective of the project was; to contribute to an improvement of the wellbeing of the most vulnerable communities in Ethiopia through better sexual and reproductive health (SRH) services and informed family planning (FP) choices. Specific objectives of the project was to improve the demand for and access to quality SRH and FP services of the most marginalized and vulnerable women and adolescents, living in 20 Woredas of Amhara and Afar Regional State.
The project has been directly targeted 1,200,000 marginalized and vulnerable women and adolescents aged between 15-49, with a special focus on 144,000 adolescent girls aged between 15-19 years in Amhara and Afar Regions. Grassroots interventions was carried out in 10 Kebeles[1] per Woreda, giving a total of 200 targeted Kebeles. The project also targeted 200,000 young males, 10,600 community leaders, elders and policy makers, 1200 teachers; 500 law enforcement officers; 400 health workers at all levels, 400 Health Extension Workers (HEWs) and 13,250 Health Development Armies members (HDAs) and volunteers; 200 local relevant authorities (Zonal and Woreda government sectors). Indirectly the Action also targeted 2,400,000 inhabitants in the 20 selected Woredas in both Afar and Amhara Regional States.
As the part of the project activities and Save the Children evaluation guide line, this terms of reference (ToR) is prepared to carry out a comprehensive endline evaluation using OECD/DAC evaluation criteria by incorporating project indicators to measure the impact and effective implementation of project activities compared to the baseline and the targets set at the inception phase of the project.
2. CONSULTANCY SERVICE DESCRIPTION
The overall purpose of the final evaluation is to assess whether the project objectives were achieved and brought the expected outcome in the lives of marginalized women and girls in Afar and Amhara region. The evaluation findings are also intended for learning and accountability purposes. Moreover, the evaluation study will document key findings, lessons learned, and recommendations which will be shared with the youth groups, key government stakeholders, nors, and other organizations working on SRH area in order to inform future work.
Last but not least, the findings of the evaluation are expected to give direction for future interventions in Save the Children’s SRH programming and will be shared with the Ministry of Health to influence policy level discussion.
3.1. Major Objective
The major objective of the endline evaluation is to measure the project outcomes against the intended plans; and assess the overall project relevance, effectiveness, efficiency, coordination, impact and sustainability.
3.2. Specific Objectives
The specific objectives of the evaluation include both the outcome and evaluation objectives of the project. Outcome objectives
(a) To what extent the project contributes to the reduction of maternal mortality ratio in Ethiopia
(b) To what extent the project contributes to the reduction of HIV prevalence (15-49 years) in Ethiopia
(c) To assess the % increase in skilled antenatal care coverage in project intervention sites in Amhara and Afar regions compared to the baseline and intended planned outcomes.
(d) To assess the % increase the total demand for FP methods in project intervention sites in Amhara and Afar regions compared to the baseline and intended planned outcomes.
(e) To determine the % improvement in community knowledge, attitude and practices on SRH, HIV and social and cultural factors contributing to high maternal deaths and morbidities compared to the baseline and intended planned outcomes.
(f) To determine the % increase in contraceptive prevalence rate in project intervention sites in Amhara and Afar regions compared to the baseline and intended planned outcomes.
(g) To assess the % increase in proportion of deliveries attended by skilled health personnel in project intervention sites in Amhara and Afar regions compared to the baseline and intended planned outcomes.
(h) To determine the % increase in proportion of health centers that provide Basic Emergency Obstetric and Newborn Care according to national quality standards in project intervention sites in Amhara and Afar regions compared to the baseline and intended planned outcomes.
(i) To assess the % reduction of incidence of social and cultural factors contributing to high maternal deaths and morbidities and barriers of access to maternal care services in project intervention sites in Amhara and Afar regions by the end of the project compared to the baseline and intended planned outcomes.
(j) To assess the % increase in allocation, distribution and utilization of SRH-FP available resources by target health offices and woreda cabinets by 2019” compared to the baseline and intended planned outcomes.
Evaluation Objectives
(k) To what extent the project is appropriate to the priorities and policies of the target group, recipient and donor
(l) To measure whether the project achieve its intended objectives
(m) To what extent the project adapted the most cost effective process and strategies to achieve the intended project objectives
(n) To assess both intended and unintended results and impacts of the project on the effort to reduce maternal mortality and family planning coverage in the project implementation sites
(o) Assess to what extent the project activities and benefits will be incorporated in the government plan and continue benefiting the communities after the end of the project
(p) To assess the degree of participation and coordination of various stakeholders and involvement in the project design, implementation and evaluation;
(q) Assess the extent to which the project has been accountable to the target groups (women, adolescents, youth, and the wider community).
(r) To identify and document lessons learnt (4 case reports) due to the project implementation, and recommend the best practices for long term Adolescent Sexual and Reproductive Health (ASRH) and family planning program improvements
The evaluation will collect evidence on the accomplishments of all expected results as outlined in the project document, indicators, logical framework, and the detailed implementation plans. The study will get data from community members living in target Kebeles (in particular: girls, adolescents, women, traditional leaders, parents), target health facilities, schools, youth/women clubs and associations, key government stakeholders. The study will also assess the effect of child migration on SRH-FP implementation in target Woredas and Kebeles. Women, adolescent girls and boys will be active participants in the process of tools design and study implementation.