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Call for proposals – Project evaluation
Brief History of On Call Africa
On Call Africa was established in 2010 by a group of doctors and international development experts to address poor access to quality healthcare in remote rural Zambia, and work towards Universal Health Coverage. The organisation is registered as a SCIO in Scotland, and a Public Benefit organisation in Zambia. We continue to be led by a skilled board of trustees in the UK, with support from a growing team of staff and volunteers both in the UK and Zambia. Thanks to growth in the last two years, we have been able to pivot from an organisation delivering services through UK volunteer doctors, to an organisation that delivers quality improvement and health system strengthening work with support from skilled medical volunteers. Our shift in approach is driven by a desire to continue to utilise the skills of experienced medical volunteers, who can add value to the Zambian health system, while ensuring that our work builds long term capacity in a sustainable way. Rather than deliver mobile medical services in rural communities, we now support the quality improvement of rural health facilities to enable them to better carry out rural outreach services themselves.
As an organisation we strive to support the achievement of national strategic objectives, while ensuring that we listen to and are responsive to the communities that we support.

Our Vision
A world where all rural communities have access to quality healthcare as close to the home as possible.

Our Mission
To improve health outcomes for marginalised rural communities in Zambia by improving access to quality healthcare.

What we do
1. Improve access to quality healthcare in rural Zambia
2. Improving water, sanitation, hygiene, and waste management in rural healthcare facilities
3. Strengthening national community-based volunteer programmes
4. Influence policy and practice at all levels of the health system in Zambia

The Project to be evaluated
Over the last six months On Call Africa have supported the Ministry of Health (MOH) to work towards their national strategic objective of designing a model rural health system. Through this process we have helped the MOH to pull together and build on the existing standards for rural health facilities and explore what interventions could help to address gaps that exist. We have piloted the assessment phase in two rural health facilities and used this information to design quality improvement plans for the facilities with health facility staff, communities and Zimba District Health Office. As part of this we have delivered training to health workers and neighbourhood health committees.
Our intention is to carry out the planned quality improvement plans over the next 18 months and build evidence for interventions that could be adopted by the Ministry of Health at scale. We are seeking an independent evaluation at this stage to help us review work completed to date and to help us review and revise existing quality improvement plans.

Evaluation brief
We are seeking an external consultant to carry out an independent evaluation of our project to help us learn from the pilot phase and see where improvements can be made. The selected consultant will be asked to evaluate the impact of the project on the capacity of health workers and neighbourhood health committees attached to the two facilities.
The consultant will also review the project concept note, assessment tools and quality improvement plans that have been developed, as well as the processes that we have followed in project design. We will then ask that the consultant prepares a report outlining the strengths and weaknesses of the approach we have taken and identifies areas where we could make improvements.
To carry out this research project we expect the consultant to visit the two rural health facilities in Zimba District to carry out face to face interviews with health workers and neighbourhood health committees. They will also be asked to carry out remote interviews with a selection of On Call Africa staff and volunteers that have worked on the project, and District Health Office and Community Health Unit staff who have been involved in its design.

Objectives of the evaluation
• To assess the project’s performance and achievements vis-à-vis the project’s overall outcomes and outputs.
• To assess the project’s relevance, effectiveness, efficiency, impact, sustainability, and community participation.
• To generate lessons learned from the implementation of the project’s activities and the outcomes achieved that will be useful for similar projects in the future.

Key questions to consider
Relevance / Are we doing the right things?
• How relevant has the OCA systems strengthening approach been in improving access to and quality of healthcare at the community level?

Effectiveness / Are we doing the right things well?
• To what extent have our interventions/approaches achieved, or are expected to achieve:
a) Improved access to quality healthcare services for the wider community.
b) Strengthened community structures?
Efficiency / How well are resources being used?
· Were the resources (funds etc) used well?

Impact / What differences have our interventions made?
• What significant changes has the project brought in healthcare delivery at the two facilities ?
• What has been the progress towards the actual project impact?
Sustainability / Will the benefits last?

Evaluation deliverables
1. Inception report
The inception report will be delivered to On Call Africa after the initial meeting and desk review have taken place and will be presented to the key On Call Africa and partner representatives in a meeting. The report should include the purpose and objectives of the evaluation, clarification, interpretation and elaboration of the evaluation questions, a detailed plan of how the evaluation will be carried out describing research methodology (including a clear methodology on how the community will be involved in the evaluation process), sampling strategy, proposed draft data collection tools (both qualitative and quantitative) together with a matrix lining the suggested methods and tools with the project indicators and evaluation questions they are supposed to answer. Methodology to address data quality issues should be explained in the report.
2. The inception report should also provide a clear matrix indicating the persons involved in the evaluation and their roles, the key internal and external stakeholders to be involved, a detailed work plan with expected outputs/deliverables and timeline and a detailed financial breakdown including the number of days and persons involved should be annexed to the report. A detailed plan on enumerator training, including persons to be trained, contents and duration of training and translation provided should be included. Report on whether the project has increased capacity of health workers
3. Report on whether project has increased capacity of Neighbourhood Health Committees
4. Report on effectiveness of our new approach and processes, and evaluate success, shortcomings and sustainability of our model
5. Powerpoint presentation on findings

Interviews required:
• 6 health workers – for deliverables 2-4
• 10 NHC members – for deliverable 3
• 3 OCA staff – for deliverable 4
• 3 OCA volunteers – for deliverable 4
• 3 DHO staff members – for deliverables 2-4
• 2 Community Health Unit members – for deliverable 4

Desk based reviews
• Review assessment tool
• Review assessments
• Review QI roadmap
• Review concept note
• Review relevant Ministry of Health documents
Payment terms
50% of the fee for consultancy will be paid once an inception report has been approved by OCA, the remaining 50% will be paid once the final report has been approved.

Expected time requirements
14 days total – field trip costs will be covered by On Call Africa
We expect the project to commence in March, and be completed by 31st March 2022

Submission Procedure
In order to apply for this role, please submit the following documents to recruitment@oncallafrica.org by 17:00 11th February 2022:
• Technical proposal
• Financial proposal
• CV – outlining similar work carried out
• Two references from organisations where similar work has been completed, including a sample of the work.

Person specification Team Leader
• Masters in public or global health
• Relevant experience carrying out project evaluations (preferably in health systems strengthening)
• 5 years experience in monitoring, evaluation and learning

To apply for this job email your details to recruitment@oncallafrica.org