CONSULTANCY OPPORTUNITY- PROJECT MID TERM EVALUATION

Terms of Reference

EVALUATION OF OUTCOMES ACHIEVED THROUGH INTEGRATED HIV/AIDS AND TB PREVENTION, CARE, AND TREATMENT PROGRAMS IN ZAMBIA

Evaluation Summary

USAID Action HIV Contract Number: 72061121C00006
Program Phase: June 2021 to June 2026

Evaluation Purpose

Determine patient and program characteristics associated with HIV prevention, HIV testing and linkage into care, ART initiation, PMTCT, and differentiated service delivery and patient health and behavioural outcomes including seropositivity, retention in care, disease progression, mortality, viral suppression, and re-engagement in care after loss to follow-up (LTFU).
Patient and program characteristics associated with TB screening, diagnosis, prevention, and patient outcomes.

Assess the identification of non-communicable diseases, outcomes, coverage, integration, and quality of programs supported in Action HIV supported facilities.
Assess the integration of HIV/TB/NCD services with other emerging global pandemics.

Evaluation Type
Mid-Term Evaluation
Primary Methodologies
Retrospective observation study

Secondary analysis of routinely collected project data.

Quantitative & Qualitative
Commissioning Organization

Right to Care Zambia

Proposed Evaluation Start: 15th April, 2024
Anticipated Evaluation End: 01 June, 2024
Anticipated Evaluation Release Report Date: 05th July 2024

BACKGROUND INFORMATION

USAID Action HIV is providing Direct Service Delivery (DSD) to the Ministry of Health in the rural Northern part of Zambia; Luapula, Muchinga and Northern provinces under the contract Number: 72061121C00006.  The Programme is designated for five years and was rolled out from June 2021 and with an expected end in June 2026.

USAID Action HIV Project Goals and Objectives

The goal of the USAID Action HIV project was to support the Government of the Republic of Zambia (GRZ) to achieve and maintain HIV epidemic control through the provision of biomedical prevention package of care to those at risk, early identification of new infections, early initiation of highly efficacious treatment regimens, and retaining those on treatment in care. The purpose is to reduce HIV mortality, morbidity, and transmission by achieving the UNAIDS and PEPFAR goal of 95/95/95 HIV treatment coverage and providing comprehensive HIV prevention, care, and treatment maintenance services in Luapula, Muchinga and Northern provinces. Project

Objectives are the following:

• Ensure access to comprehensive HIV prevention interventions.
• Initiate 95 percent of those who tested positive on ART.
• Ensure that 95 percent of those on ART are virally suppressed.
• Reach 90 percent of eligible HIV positive adults and children with NACS and integrated voluntary family planning services in 95% of HIV service delivery points
• Provide cervical cancer screening services for WLHIV at HIV service delivery locations.
• Provide tuberculosis preventive treatment.
• Strengthen M&E capacity at the facility, district, and provincial levels for improved program management.
• Strengthen facility level commodity management to mitigate the risk of stock outs.
• Strengthen the public financial management systems of the Ministry of Health and Ministry of Finance to enable the efficient use of direct G2G funds from USAID.

THE SCOPE OF THE EVALUATION

The main aims for the use of routinely collected data for analysis through this protocol are to assess outcomes for clients reached through USAID Action HIV’s programs as well as to measure individual and population-level outcomes over time and associated program implementation interventions and strategies.  While the mid and end evaluations are more summative – the continuous evaluation is data driven through weekly, quarterly performance evaluation meetings. These provide an opportunity to identify gaps and strategies that are working.  At mid-term and end term – the evaluation will include all implementation science outcomes.

• Reach 90 percent of eligible HIV positive adults and children with NACS and integrated voluntary family planning services in 95% of HIV service delivery points.
• Provide cervical cancer screening services for WLHIV at HIV service delivery locations
• Provide tuberculosis preventive treatment.
• Strengthen M&E capacity at the facility, district, and provincial levels for improved program management.
• Strengthen facility level commodity management to mitigate the risk of stockouts.
• Strengthen the public financial management systems of the Ministry of Health and Ministry of Finance to enable the efficient use of direct G2G funds from USAID.

PURPOSE, OBJECTIVE, SCOPE, INTENDED USE OF THE EVALUATION

Purpose and Objective of the evaluation

Routinely collected data is aggregated across all facilities in all districts and used to inform program improvements as well as contractual reports generated from the direct service delivery for the Zambia MOH, United States Government (USG) through the USAID country office in Zambia.

The aim of the protocol is to facilitate detailed analysis of routinely collected data to inform program performance, coverage, quality of care and services, and how it impacts on the intended population. The protocol will assess outcomes for clients reached through the USAID Action HIV programs and its partners as well as to measure individual and population-level outcomes over time and associated program implementation interventions and strategies. The analysis will take into consideration other co-morbidities, and emergency infections.  The protocol also provides for mid and end term evaluation looking at impact, effectiveness, efficiency, sustainability, fidelity and relevance.

The objectives of this study are to describe:

Describe clients and program characteristics associated with HIV Prevention, HIV testing, yield, linkage into care, PMTCT, and differentiated service delivery and patient health and behavioural outcomes including retention in care, disease progression, mortality, viral load coverage, viral suppression, and re-engagement in care after becoming lost to follow-up (LTFU).
Patient and program characteristics associated with TB screening, diagnosis, prevention, active and latent TB treatment and patient outcomes including completed treatment, cured, transferred out, treatment failure, defaulted, and died.
Assess the identification of non-communicable diseases, outcomes, coverage, integration, and quality of programs supported in supported facilities.
Describe clients and program characteristics for nutrition assessment, and gender-based Violence (GBV)

EVALUATION CRITERIA AND KEY LEARNING QUESTIONS
Re-AIM (reach, adoption, implementation, and maintenance) will be used to adequately assess effectiveness of USAID Action HIV interventions and the associated overall program implementation process. This framework has been selected due to its applicability to evaluating public health, behavioural science, and implementation outcomes across clinical, community, and corporates contexts. The evaluation will compare the situation before and after the USAID Action HIV program was introduced in the supported facilities with the purpose to reduce HIV mortality, morbidity, and transmission by achieving the UNAIDS and PEPFAR goal of 95/95/95 HIV treatment coverage and providing comprehensive HIV prevention, care, and treatment maintenance services.

The following questions are being pursued in part or whole depending on type of evaluation (continuous and specific project time points) and do apply for all objectives.

How did the project perform towards meeting its set targets?
To what extent have planned activities and outcomes been achieved?
Was the project implemented as proposed in its onset?
What were the enablers or barriers for the achievements reported?
What other activities might be more effective?
How did adaptive management or continuous improvement occur?
Were resources (humans, costs, time) allocated strategically, used efficiently in a timely manner to obtain the reported achievements?
What were the level of stakeholder’s involvement in the project implementation?
Inclusion criteria: Indicators found within routine summary reports generated by services provided at health facilities, districts, or health directorates supported by Action HIV.

Exclusion criteria: None.

METHODOLOGY
This is a mixed method design –protocol that includes secondary analysis of routinely collected patient-level clinical, laboratory, facility, community, and program data and qualitative data where appropriate. The protocol is solely for administrative purposes; hence it does not have any interventions(experimental) being tested, however it shall take into consideration all interventions put in place to improve performance during implementation. It also encompasses the mid and end line evaluation additional questions will be applied to answer implementation outcomes questions such as – relevance, sustainability, diffusion.  These then will require qualitative methods: key informant interviews, focus group discussions, involving different populations to provide for collaboration with quantitative findings.

The Evaluator is expected to align with and adhere to the USAID Evaluation Policy.

AUTHORITY AND RESPONSIBILITY

The Consultant roles and Responsibility

• Develop a work plan to carry out the tasks spelt out in the scope of work.
• Desk review of relevant programme, project documents, internal system and reports such as proposals, assessments, project budgets, monitoring and assessment reports, publication etc.
• Review and enhance the analysis plan.
• Establish working contacts with all the relevant stakeholders.
• Prepare and submit to RTCZ the evaluation proposal and the inception report including methodology to be used, work plans and schedules for both quantitative and qualitative aspect of the assignment for review and feedback and approval by RTCZ.
• Facilitate the process of development of conclusions and key recommendations through a one-day workshop.
• Produce a near-final draft evaluation final report and slide deck.
• Finalize the mid-term evaluation report.
• Compile and submit all data.

RTCZ Responsibilities

• Briefing of the evaluator and approve the study tools and methodology.
• Brief stakeholders about the purpose of the evaluation
• Provide all the necessary support to the consultant to ensure timely completion and compliance with the international survey standards.
• Avail all the required facilitation and coordination.
• Assist in organizing meetings with stakeholders.
• Prepare and effect payment for the consultant upon completion of the assignment.

Logistics

Project Coordinator in close coordination with partners will be required to support the consultancy firm as much as possible to secure logistics preparation needed throughout the whole process of the evaluation.

BUDGET

The consultant will develop a detailed budget and work plan based on the details in the TOR.

TIME PLAN AND DELIVERABLES

The evaluation is supposed to be carried out within a period of 40 working days. Below we provide the main deliverables of this evaluation:

Deliverable / Date

Inception report Submitted & Presented
15th April 2024

Draft Evaluation report
1st June, 2024

Stakeholder Workshop
20st June, 2024

Final evaluation report
05th July, 2024

BRIEFING AND DEBRIEFING WITH RTCZ CONSORTIUM AND STAKEHOLDERS

Before and at the end of the field phase, a Briefing and Debriefing, involving Project Management Team, Consortium and USAID will take place. Preliminary findings will be shared in the form of a presentation or similar.

DRAFT AND FINAL EVALUATION REPORT

The draft and final evaluation reports should include the following sections:

• Executive summary – Summary of the evaluation, with emphasis on main findings, conclusions, lessons learned and recommendations.
• Project introduction/background including logic model and/or theories of change including brief description of the project, and its purpose, logic, history, organization and stakeholders.
• Evaluation purpose, including evaluation framework/learning questions.
• Evaluation approach and methodology, including limitations.
• Findings, organized in a clear and logical fashion that corresponds to the evaluation questions, assessment criteria, and overall project.

• Conclusions
• Recommendations
• Lessons learned.
• 3-5-page evaluation summary for sharing with internal and external stakeholders.
• Case studies, vignettes, infographics and/or stories, some of which sharable with external audiences

CRITERIA OF SELECTION OF SUITABLE CONSULTANT

The final evaluation will be carried out by one or a team of external and experienced consultants. The minimum consultant qualification requirements are:

• Demonstrated experience performing similar projects.
• Key personnel need to have master’s or doctoral degree in the health sciences, social sciences, health systems research, or a related field.
• Extensive knowledge of PEPFAR and USAID programming and reporting requirements
• More than 8 years in the field of program/project planning, program evaluation and management, health information system (HIS) strengthening, public health and/or capacity building of government entities within the field of public health and development.
• Experience in conducting of project/program evaluations/reviews.
• Strategic thinking
• Experience in strategic planning in HIV/AIDS and other sectors.
• Excellent knowledge of the health sector in Zambia, particularly HIV and/or infectious disease
• Demonstrable ability to work across multiple countries and multi-cultural sensitivity.
• Strong and proven capacity in both quantitative and qualitative methods
• Ability to mine and analyse disparate data.
• Excellent verbal, interpersonal and written communication skills
• Strong analytical, problem-solving, and decision-making capabilities
• Team player with the ability to work in a fast-paced environment.
• Strong skills in stakeholder engagement and consensus building
• Computer proficiency – Microsoft office suite applications
• Availability from April 15th, 2024, to July 30th, 2024.

APPLICATION PROCEEDURE

Qualifying consultants/firms should submit their technical proposal and budget by 27th March 2024 COB to the following email Zambiaprocurement@righttocare.org

DISCLAIMER

By applying for the above-mentioned opportunity, you consent to Right to Care to conduct qualification, ID, criminal and reference checks Should you not receive a response to your application from Right to Care within one month of this advert being placed, kindly consider your application as being unsuccessful.

Only applicants meeting the strict criteria outlined above will be contacted as part of the shortlisting process.  Right to Care Zambia is aware of fraudulent activities by certain individuals claiming to be representatives of the organization.

Be advised that Right to Care does not charge any fee at any stage of the procurement process, and as such Right to Care Zambia assumes no responsibility for any announcements or activities by such individuals or entities.