Summary
Date Posted: Saturday, April 02, 2022 , Base Salary: Not Disclosed

JOB DETAILS:
Call for Consultancy (Situational Analysis/Outcome Evaluation of NENTHSP)Terms of Reference
Consultancy to undertake a Situational Analysis of ENT services and Outcome Evaluation of the just ended Zambia National ENT Strategic Plan (NENTHSP) 2017-2021.
Beit CURE Hospital, Lusaka, ZAMBIA.
1. Assignment Summary
Program/Project: Strengthening Audiological and ENT Medical Services in Zambia.
Project Number: 3581- MYP
Partner Organisation: Beit Cure Hospital, Zambia.
Project start and end dates, Phase of project: Project Start: Dec, 2018-April,2022.
Year 3 of the final year of the Project period.
Assignment Purpose
• To assess the performance of the Zambia National Ear, Nose and Throat Health Strategic Plan (2017-2021).
• Support the development of a Situational Analysis Report based on the findings from the Outcome Evaluation using World Health Organization-Situational Analysis Tool.
Assignment/study type
Outcome Evaluation of the National ENT Strategic Plan .
Commissioning organisation/contact person: Beit Cure Hospital
Primary Methodology
Qualitative Research and Desk Review of existing ENT health and administrative data.
Proposed Start and End Dates
11th – 15th April, 2022
Anticipated Report Release Date
19th April, 2022.
2. ORGANIZATION AND PROJECT BACKGROUND
The Beit Cure Hospital (BCH) is a recognized pediatric teaching hospital specialized in the treatment and care of children with disabilities. The mission of the hospital is to treat orthopedic conditions as well as ear, nose and throat (ENT) conditions. The hospital is equipped with an out-patient department for ENT services and is currently one of the few hospitals in Zambia that can perform certain complex operations such as operations in the middle ear, the cleft lip and cleft palate as well as undertake certain Audiometric tests such as Auditory Brainstem Response tests (ABR’s) and Auditory Steady State Response tests (ASSR’s). The Hospital is situated on the outskirts of Lusaka, the capital of Zambia and was officially opened in December, 2006.
2.1 Project Background
Based on estimates for Sub-Saharan Africa by The World Health Organization (WHO), between 670,000 and 1 million (4-6%) people are affected by hearing impairment in Zambia. With a high prevalence rate of HIV (12.4%) and opportunistic infections such as TB, it is safe to assume that Zambia has a high ENT disease burden such as hearing impairment compared with countries with a lower HIV prevalence. Hearing impairment like other types of disabilities has been linked to poverty. People living in poverty are exposed to a higher risk of acquiring hearing impairment due to poor accessibility to health care services (e.g., treatment of otitis media). Furthermore, this vulnerable group is exposed to more harmful external influences (e.g., noise, occupational hazards due to inadequate protection).
Hearing impairment if left undiagnosed can have devastating developmental results in children. Hearing is critical to speech development, communication and learning. Poor academic performance as a consequence of learning problems can have a significant impact on vocational choices. Children with hearing impairment also face difficulties interacting in a spontaneous way. They also tend to be labelled negatively and as a result end up being isolated from their peers and are left depressed. Once deafness is identified in a child, he/she will have to receive special education, which is very costly in developing countries. Income of individuals with Hearing Loss in the third world is estimated to be 40-45% less than the hearing population in developed countries. The negative impacts of HL in can be mitigated through early diagnosis and proper management of the HL through prevention and promotion, treatment and rehabilitation.
To achieve this, it is necessary for the population to have access to ENT services at the various levels of health services in Zambia’s health system. Unfortunately, this is not a reality in Zambia and this has been clearly highlighted in the National ENT Health Strategic Plan (2017-2021). A number of cooperating partners such as the Christian Blind Mission (CBM), the Federal Ministry for Economic Cooperation and Development Germany (BMZ) and Beit CURE Hospital joined efforts with Ministry of Health (MoH) to strengthen ear and hearing care services in Zambia through the implementation of the BMZ/CBM “Strengthening Audiological and ENT Medical services in Zambia” which was a 3 year project implemented with 3 provinces in Zambia which include Lusaka, Central and Southern Provinces.
2.2 Rationale and Context of this Assignment:
In 2014, the National ENT conference established the National Ear, Nose and Throat Health Committee (NENTHC) which included experts for the Zambian government, various non-governmental organisations (NGO) (including BCH and CBM) and the WHO. This committee developed the National Ear, Nose and Throat Health Strategic Plan (NENTHSP), which was adopted by the Ministry of Health in October 2017 and operationalized in February 2018 through a nationwide stakeholder workshop supported by CBM in Lusaka. The workshop was conducted by the National ENT Coordinator of the Ministry of Health. CBM provided assistance to the Zambian government by providing the expertise of an ENT surgeon/specialist who with the National ENT Health Committee played a central role in elaborating some of the gaps within the Zambian Health System related to ENT service provision. Some of the gaps identified included the training of specialist personnel, provision of quality ENT equipment and infrastructure as well as looking into the revision of ENT Curricula in Zambian nursing education providers. To date the support rendered through BCH, BMZ and CBM to the Ministry of Health has indirectly contributed towards strengthening ENT and Audiology services in Zambia. Beit CURE and its partners have also been instrumental in the development of the first ever National ENT Health Strategic plan which is coming to its end in December 2021.
Based on the background provided, Beit CURE now seeks the services of a Consultant to review the 2017 – 2021 National ENT strategy in collaboration with the Zambia National ENT Coordination Office at the Ministry of Health. The consultant shall be expected to use the World Health Organization’s Situational Analysis tool to help stakeholders understand the context and the prevailing situation on the ENT health care sector. The development of the Situation Analysis Report shall provide sufficient evidence and justification for the development of strategies that shall be put in place to ensure that ENT in Zambia is adequately addressed.
2.3 Target group and main stakeholders of the Assignment
Below is the stakeholder’s analysis table of all relevant stakeholders that must be engaged by the consultant to gather adequate feedback for this assignment to be successfully undertaken.
NAME PRIMARY STAKEHOLDER / LEVEL OF INFLUENCE / LOCATION / STAKEHOLDER DESCRIPTION
1. Ministry of Health- National ENT Coordinator’s Office
High
(The Consultant will be required to work hand in Hand with this Office/Officer throughout the entire process of developing the ENT strategic health plan)
-Lusaka (H.Q)
-Zambia’s focal point on ENT services and the National Technical Officer on between WHO, ZENTAS Society and the Ministry of Health.
2. Zambia Ear Nose, Throat and Audiology Society (ZENTAS)
Medium
-Lusaka (H.Q)
-Society of ENT/Audiology specialists who diagnose Ear diseases.
3. Ministry of Health-Head of Clinical Care
High
• -Lusaka (H.Q)
• -The Clinical Care director or head of Clinical services in Zambia.
• 4. Provincial Health Offices (PHO’s)
• High
• -Kabwe
• -Lusaka
• -Choma
• -(All other provincial health offices if and when it is required)
• -Government administrative office responsible for of all provincial related health services provided to the public.
• 5. District Health Offices (DHO’s)
• Medium
• -Kabwe, Kapiri, Chibombo
• -L/Stone, Zimba, Choma, Kalomo
• -(All other provincial health offices if and when it is required)
• -Government administrative office responsible for of all district related health services provided to the public.
• 6. Chief Medical Director’s Office/Hospital Superintendent
• High
• -Kabwe (KTH)
• -Lusaka (BCH, LMTH, UTH)
• -Livingstone (LTH)
– The administrative Head of a Hospital responsible for the day to day running of the institution.
• 7. Trained ENT Health Staff in Primary Ear and Hearing Health and Audiology.
• Medium
• -Kabwe
• -Livingstone
• -Lusaka
• -Ear, Nose and Throat and audiological trained healthcare workers who provide Ear related services to all patients that visit the medical hospital.
• 8. BCH Project Team
• High
• -Lusaka (H.Q)
• -BCH Project team responsible for various ENT related project support functions.
• 9. CBM Country Office
• High
• -Lusaka (H.Q)
• -CBM project team funding and supporting BCH in project implementation.
• 10. Starkey Hearing Institute
• Medium
• -Lusaka (H.Q)
• -Renowned Audiology training institute based in Zambia also provides Audiology services across the country.
• 11. Deaf Kids International (Formerly known and Sound Seekers)
• Medium
• -Lusaka (H.Q)
• -Audiology service provider based in Zambia and key in dispensing Hearing Aids across multiple partners.
2.4 Project Structure:
This project supporting this assignment (the BMZ/CBM ENT project-P3851) is based on a multi-level approach defined below:
1. At the macro level, it aims to permanently establish ENT medicine with a focus on otology in Zambian health policy and the health system.
2. At the meso level, the aim is to train and further qualify a sufficient number of medical and paramedical specialists in order to enable successful ENT and especially ear medicine services. In all training activities the aim is to have a balanced gender ratio.
3. At the micro level, the aim is to reduce the large number of untreated people, especially from low income groups. The qualification of the personnel and the establishment of ear medical services on the level of primary health care are crucial for this.
The development of the National ENT Health Strategic Plan is a Macro-level activity to be implemented before the close of the project and is supposed to yield a new strategic direction that shall contribute towards strengthening the already existing Zambian ENT health system.
3. Timeline of The Deliverable
• Technical Proposal Submission by Consultant. (7th of April, 2022)
• Communication made to the selected Consultant. (8th of April, 2022)
• Kick-Off meeting to commence the development of the Situational Analysis.(11th of April, 2022, 40% Payment Made).
• Data Collection and Desk Review commences with Project Stakeholders. (12th of April, 2022)
• Draft Report submission by Consultant. (15th of April, 2022)
• Final Report is submitted BCH/MOH and its partners. (19th of April, 2022, 60% payment made)
• Dissemination Workshop of the situational analysis report. (week of the 26th of April, 2022)
4. Methodology
4.1 Objectives of the Assignment
a. The Main Objective:
• To develop a high quality and prudent Situational Analysis Report which assess the outcomes of the just ended National ENT Strategic Health Plan for Zambia for the period starting 2017 – 2021.
b. Specific Objective of the Assignment:
i. To develop a Situational Analysis (report) on Ear and Hearing Care in Zambia.
ii. Conduct and Outcome Evaluation on the just ended National ENT Strategic Plan 2017-2021.
4.2 Research Methodology
The methods described below may be used for gathering the information for the questionnaire:
a. Desk-based data collection
Information such as the country profile, burden of disease, epidemiology of hearing loss, and health status indicators can be obtained from existing peer-reviewed literature, WHO statistics, the national statistics office/board and Ministry of Health documents.
b. Key informant Interviews with relevant stakeholders who should include but not limited to the following:
i. Ministry of Health
• Focal point for hearing care, noncommunicable diseases or disability
• Focal point for maternal and child health programmes
• Focal point for tuberculosis and HIV/AIDs programmes
• Other officials, as required; a list of possible interviewees and their contact details shall be availed to the consultant.
• World Health Organization (country office staff)
• Representatives of associations of people who are deaf or hard of hearing, community-based rehabilitation programmes and disability rights organizations.
• Key professionals involved in ear and hearing care service provision or planning in the country; such people can be identified through the Ministry of Health or professional organizations.
• Members of statutory bodies, such as councils of health professionals.
• Officers of professional organizations and societies, e.g., and of ear, nose and throat specialists, otologists, audiologists and public health specialists.
• Representatives of training institutions.
• Local and international NGOs working in the field of ear and hearing care.
c. Review and analysis of information
The information collected should be collated and organized in the provided format. Sources of information should be recorded as far as possible. Where documentary evidence is not available, the source or person who provided the information should be included in the list.
d. Summary Tables
Summary tables should be completed carefully and used to record the progress of the country on different aspects of ear and hearing care services, over a period of time.
5. Management of the Assignment
Office/Name
Role within the evaluation exercise
i. Beit Cure Hospital
• Selection the consultant.
Beit Cure Hospital
• Provide support for the consultant’s logistics, if/when requested in terms of respondents, accommodation, transport etc.
Ministry of Health Zambia, National ENT Coordinator/Technical Officer on Ear and Hearing Care in Zambia.
• Shall work hand in hand with the consultant and provide overall guidance on the current affairs of ENT in Zambia. The coordinator shall also serve as the liaison person between the consultant and Beit CURE Hospital.
6. Consultant Requisite Qualifications
The consultant will be required to have the following attributes:
• Master’s degree (PHD Preferred) in the fields Public Health, Epidemiology, Demography and Population Studies.
• Must have developed or played a key role in the development of a National Strategy for non-communicable diseases for the Ministry of Health is a must.
• Practical knowledge in assessing Ear and Hearing programmes from gender lens, disability inclusive lens and good knowledge of strategic project management of health-related projects.
• Practical experience in undertaking Health research particularly with a focus on non-communicable diseases will be an added advantage.
• More than 10 years of experience undertaking complex studies particularly in the field of epidemiology of non-communicable diseases (preference) and communicable diseases with proof of at least 3 high level referees.
• More than 10 years’ experience undertaking various research studies, preferably prevalence studies in the field of public health primarily focusing on undertaking tasks related to project management, monitoring and evaluation, statistical analysis, application of quantitative methods.
• Knowledge of participatory methods in evaluations, prevalence surveys and epidemiological studies;
• Strong and proven capacity in both qualitative and quantitative methods;
• Excellent English speaking, writing and comprehension skills
The Consultant will take overall responsibility for the fulfilment of the ToR, and is obliged to adhere to BCH and CBM’s Code of Conduct and Child Safeguarding Policy and will be requested to sign related documents with the contract.
7. Attachments
The following documents will be availed to the consultant prior to the consultancy service:
• CBM key documents (to be agreed on and undersigned by the consultant/consultancy team).
o Child Safeguarding policy.
o CBM Code of conduct.
• BCH Project Proposal documents
• The current National ENT strategy (2017-2021)
• Summary data on ENT statistics

Education Requirement: No Requirements

Job Experience: No Requirements

Work Hours: 8

Job application procedure
To apply for this job email your details to chota.musonda@cureinternational.org 

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