Amref Health Africa, the largest African led international organization on the continent, provides training and health services to over 35 countries in Africa. Founded in 1957 as the Flying Doctors of East Africa to bring critical health services to remote communities, Amref Health Africa now delivers technical assistance on community-based health care.
Although Amref Health Africa has been formally registered in Ethiopia in 1998, a full-fledged country program with a country office started in 2002. Since then, the country program has grown from one project in Addis Ababa to more than 20 projects in Afar, Amhara, Benishangul-Gumuz, Gambella, Oromia, SNNP, Ethiopia Somali regions and nationwide health systems strengthening interventions focusing the capacity building of the national Health Extension Program.
Through its BMGF funded IPHCSD project, Amref works to ensure access to and utilization of life saving RMNCH services, ensure quality of essential health service and strengthening governance and accountability through bidirectional accountability and managerial accountability for PHC.
2.1 Background
As part of its commitment to ensuring universal health coverage, Ethiopia aspires to provide the full spectrum of essential and equitable high-quality health services by strengthening the primary health care system (PHC). As part of this effort, the HEP roadmap has been launched in 2021 to guide the development of the HEP in the broader primary health care context. Following the launching of the roadmap, Bill and Melinda Gates Foundation developed a project called Improving Primary Health Care Service Delivery (IPHCSD). This investment, which will be implemented through a partnership between Amref and JSI Research & Training Institute, Inc. (JSI), aims to strengthen the functionality of and bidirectional linkage across Ethiopia's PHC delivery platforms—health post (HP) to the health center (HC) to the primary hospital (PH)—for improved reproductive, maternal, newborn, child, adolescent health, and nutrition (RMNCAH-N) outcomes. This project will strengthen health system capacity to implement the HEP roadmap, pressure-testing PHC service delivery approaches and modalities, and provide the evidence base to inform improved national PHC policies, leverage larger financing mechanisms, and transform PHC service delivery for improved health outcomes.
As such, this investment, over five years, will focus on approaches that contribute to three objectives at the PHC level: 1) ensure equitable access to and use of essential health services; 2) improve the quality of essential health services, and 3) strengthen technical oversight and accountability. The project will be implemented in eight regions of Ethiopia: Amhara; Oromia; Sidama; Southern Nations, Nationalities, and People’s (SNNP); Southwest Ethiopia Peoples; Afar; Somali, and Gambella. These regions were selected to represent agrarian, pastoralist, and agro-pastoral contexts.
This study proposed to use a qualitative research method for deeper understanding and specifically an ethnography as a research method which elicits a valuable body of knowledge by observing, inquiring, and understanding peoples’ experiences, interpretations, their interactions, and relationships surrounding an issue in a real-life context[1],[2]. The overall goal of the ethnography is to obtain information on conditions and behaviors of the community in a pastoralist setting that are important for various decision-making activities, including: (1) codesigning interventions that are appropriate for local conditions; (2) identifying potential enablers and bottle-necks that are likely to affect the success of the implementation; (3) co-designing and developing community engagement strategies and; (4) seek early information whether proposed interventions are likely to be feasible or effective in a given environment.
This study will comprise Afar, Somali regions and South Omo Zone of SNNP in Ethiopia each of which are predominantly pastoralist communities with chronic under utlisation of maternal and child health services. There is limited data about the perception of the community and on the coverage, quality and efficiency of health services across these regions.
Amref Health Africa is looking for a consultancy company to conduct ethnographic study on maternal service utlisation in pastoralist setting with particular focus in one woreda in each of the following regions: Afar, Somali regions and Dasenech Woreda of South Nations and Nationalities.
Therefore, this RFP is developed to identify the general scope of work and specifically to clearly articulate the required work, period of engagement, qualifications and deliverables expected from a consultant that will engage in the work.
To support this evidence generation AMREF Health would like to appoint a consultant with experience to conduct an ethnographic study of the pastoralist health service delivery and provide recommendations on how AMREF health can continue to strengthen the pastoralist primary healthcare services.
The overall objective of this work is to synthesize and consolidate evidence from a focused ethnographic study that will inform AMREF’s co-design and implementation of MNH interventions in pastoralist setting by gaining deeper insights into the experience of pastoralist women’s access to maternity health services, the facilitators and barriers that exist, and the influence of cultural beliefs and practices on these experiences
To undertake this anthropological research, we are seeking for an experienced ethnographer currently working (or recently) with pastoralist communities, and ability to conduct focused ethnographic study. The expert should have previous experience on working with pastoralist communities, setting focus group discussions and conducting observations and know the context.
The methods used to collect and analyze data should ensure and meet quality standards. The consultant will prepare or adopt appropriate method and tools, which covers the key areas identified in the key tasks of the study.
The tools should be seen and discussed with Amref Health Africa in Ethiopia before the review starts. Standard tools which are adopted should be used for data collection. Data analysis methods should also be explained in the methods part.
The following deliverables are expected from the successful consultant: We are expecting the following key components of the assignments:
A) Inception report: The winner of the assignment consultant shall submit an inception report after signing the agreement. The inception report includes but is not limited to:
B) Draft Report. The draft report is expected from the consultant before the final report. The report will be written in the English language and must be comprehensive.
C) Conduct validation workshop for the design of the workshop: Once the consultant got the first round of feedback- The firm in consultation with project/country staff will organize validation workshop.
D) Final report and presentation of the key findings to Amref Health Africa
The consultant shall submit a final report in both hard copies and electronic copies along with all survey data sets (in Excel/Stata/SPSS compatible formats), transcripts of qualitative data including photographs and ethical approval etc. The report will be written in the English language and must be comprehensive. References will be cited after each important fact and figures. The final report should be edited by a professional, incorporating all comments and corrections if any. Completed checklists, questionnaires, case stories, quotes, photos have to be submitted to Amref Health Africa. Together with the final report, the consultant will prepare and submit to Amref a PPT presentation (Power Point) with the recap of all figures and findings and their inherent analysis.
Table of contents of the report and other formatting will be proposed by either Amref and/or the consulting firm. Findings in the report should be disaggregated. All documentation under this assessment remains solely Amref Health Africa property and no dissemination in any of the parts should be shared without Amref Health Africa consent.
Bids should be submitted in English and include the following:
Both the details of technical and financial proposals should be submitted in a separate sealed envelope.
o Proposed methodology (not exceeding 5 pages)
o Detailed proposed workplan including deliverables
o CV of the lead consultant (preference not exceeding 3 pages)
o Roles and responsibilities of any additional evaluation team members (including level of effort)
o Summary CV of any other evaluation team members detailing similar experience (not exceeding a quarter page per team member), with full CVs in annex (not exceeding 3 pages per CV)
o Samples of one or two previous similar pieces of work by lead consultant
Annexes: Any documents such as curriculum vitae, and work experiences and other information which the applicants feel will assist the proposal review team in evaluating the proposal may be attached as annex
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