INTRODUCTION

Amref Health Africa in Zambia Implemented a project Called Closing the Gap between Communities and formal Health Sector whose goal was to contribute to the Reduction of Maternal Mortality on the Copperbelt province of Zambia. The project was implemented from 2017 to 2021. During the project life cycle, no maternal deaths were recorded in the implementation sites and this could have been attributed to the respectful maternity care model in the program. Among the recommendations made during the close out meeting, were that Respectful Maternity Care be rolled out to the whole country and that RMC be included in the nursing and Midwifery Curriculum. With Support from Amref HQ, Amref Zambia is implementing a Technical Assistance (TA) initiative to support the Ministry of Health (MoH) and Nursing and Midwifery Council of Zambia (NMCZ) to institutionalize RMC in Zambia.

1.0 OBJECTIVES OF THE TA

• To support Ministry of Health in developing a pathway for inclusion of RMC in policy documents and build capacity of nursing and MCH.
• To support training regulatory authorities, develop and include RMC in Nurses and Midwives curriculum
• To disseminate the proof of concept/policy brief on respectful maternity care

1.1 OBJECTIVES OF ASSIGNMENT

Overall Objective of the Assignment

The main objective of this assignment is to document the effectiveness of the TA initiative, including the process involved in the institutionalization of RMC, best practices and lessons learned during the twelve (12) month implementation period.

Specific objectives include:

• Conduct a process review and documentation of the TA initiative while clearly highlighting the sustained and transformative changes brought about by the deployed TA modalities and approaches in Zambia.
• Identify and capture the critical success factors underpinning the effectiveness of the TA initiative in Zambia through a comprehensive review of initiative documentation, stakeholder feedback, and contextual factors, with the aim of providing actionable insights for continuity, and future planning and execution.
• Incorporate creative story-telling in the production of otherwise “dry content” for better and easier engagement
• Evaluate the return on investment (ROI) of Amrefs’ TA initiative in Zambia, in terms of sustainability, replicability and scalability of the initiative by quantifying both financial and non-financial outcomes, including but not limited to enhanced engagement among health care workers and pregnant women, providing a comprehensive understanding of the initiative’s overall impact/outcomes and how they contribute to improved health metrics and sustainable development indicators.

Learning Questions

1. Have the TA modalities and approaches deployed for this TA initiative effected sustainable and transformative change in Zambia
2. What are the key success factors for TA in this context?
3. How is this TA initiative generating a return on Amref’s investment?

Evaluation Approach:

The documentation will take the shape of desk review and administration of structured questionnaires, targeting policy influencers and health providers who were involved during the TA implementation. This will incorporate both qualitative and quantitative data, while guided by the RMC’s logical and M$E frameworks, and the aforementioned TA learning questions. While it may be hard to attribute any key changes on Maternal and Neonatal national indicators to the TA initiative due to a short implementation period, literature review that speaks to the achievements of similar initiatives across the continent and globe will be conducted. This is toward highlighting the lasting benefits and systemic changes, which result from the embedment of RMC in national policy documents.

2.0 Scope of the Work

The documentation will cover all components related to the response of the above-mentioned objectives.

The scope of works includes, but not limited to the following:

• Undertake a desktop review of the activities carried out by implementing partners (MoH and NMCZ) and other relevant RMC and activity documents to have a clear understanding of objectives and outcomes.
• Assess the organizational capacity (in Amref) to conduct TA and the perception of TA recipients (the government) on Amref’s TA.
• Based on the review and analysis, prepare an inception report including a clear cut methodology, time frame and steps to be followed to undertake the assignment.
• Undertake field visits for the collection of information with stakeholders and institutions and organise meetings with stakeholders while employing appropriate tools and methods (discussions, interactions, focussed group discussions, key informant interviews, e.t.c.) to generate information at various levels.

3.0 Outputs

The documentation would have the following outputs:

a. A brief case study highlighting the impact of RMC on health outcomes, together with the role of communities in supporting RMC in Zambia.

b. A sample of an advocacy tool, which can be adapted for RMC embedment within national policy documents, continentally and globally.

c. 20-minute full-length video as a compelling story for the public, policy makers and the donor.

d. 1-2-minute trailer for promotion of the video.

e. A maximum of 2 full length creatively written features (maximum 1,500 words each) capturing a range of voices that bring out the benefits experienced and impact of the TA initiative at national (key stakeholders, policy influencers, technical officers), sub-national (policy influencers, HCWs) and community level (beneficiaries).

f. The videos are required to be in English. Where a speaker speaks in any other language, the video will have English subtitles.

g. Documentation of the organizational capacity (in Amref) to conduct TA and the perception of TA recipients (the government) on Amref’s TA.

h. Process documentation of RMC and a one-pager write-up with guidelines for introducing RMC.

i. Quantification of resources needed to train HCWs on RMC.

j. A technical report addressing all the evaluation objectives and the TA learning questions.

3.0. Role of Amref Health Africa in Zambia

a) Provide technical oversight, quality assurance and control for the documentation process

b) Mobilize partners to effectively participate in the documentation.

c) Provide the relevant project documents for review.

5.0 Role of Provincial and District Health Teams and NMCZ

a)  Provide relevant technical staff to respond to the Consultant.

b) Provide literature that may deem relevant to the RMC documentation

6.0 Time Frame

c)  The documentation is expected to take a maximum of 10 working days. This includes the submission of the final report. The final report is to be submitted within five days of completion of the documentation.

Expected Profiles of the Consultant

The consultant should have a good understanding of Maternal and Neonatal Health service delivery in Zambia with a special focus on Respectful Maternity Care. They should be able to describe the role of Ministry of Health and NMCZ in the implementation of Respectful Maternity Care in Zambia.

The suitable candidate should also have the following skills:

1. Demonstrated track record in undertaking similar assignments with MOH and or other Partners related to Maternal Neonatal and Child Health.

2. Demonstrated ability to provide timely, evidence-based, quality assured technical reports.

3. Good proficiency in writing skills and communication skills (in English) (A sample of past reports written by the consultant is required)

4. Ability to work under strict timeline

5. Bachelor’s Degree in a related field

6. Master’s Degree will be an added advantage

Time Frame

d) The documentation is expected to take a maximum of 10 working days. This includes the submission of the final report. The final report is to be submitted within five days of completion of the documentation.

7.0 Application procedure

Interested Independent Individuals/Firms (Consultants) who meet the above requirements should submit a technical and financial proposal electronically on or before 29th March 2024 at 17:00hrs. Proposals must be sent via email to procurement.zambia@amref.org cc. brenda.mubita@amref.org; and joyce.murerwa@amref.org

A.    Selection Method Evaluation of award of Consultancy

Firms/individual consultants will be selected through a Least Cost Based Selection (LCB). The minimum technical score for qualification will be 75%. Amref Health Africa in Zambia will evaluate the proposals and award the assignment based on technical and financial feasibility. Amref Health Africa in Zambia reserves the right to accept or reject any proposal received without giving reasons and is not bound to accept the lowest or the highest bidder.