BACKGROUND

Muslim Aid supports 9 static health facilities (8 MNCHs and 1 MDR-TB) since 2022, with the projects based in Banadir, Bakool, Lower Shabelle, Hiran, and Lower Juba regions to provide quality primary health care services targeting women and children. Services planned include treatment of common morbidities, first aid and treatment of minor injuries, treatment of communicable diseases, maternal and new-born health (including comprehensive ANC, skilled delivery services, management of intrapartum complications for mothers and new-borns, timely PNC), child health services (including the treatment of malaria, pneumonia, and diarrhoea), health promotion and education, and immunization services. These facilities are further supported to monitor, track, and respond adequately to the trends in morbidities and potential outbreaks of communicable diseases such as measles and AWD caused by the protracted drought using a real-time health management information system (HMIS).

MA supports the health facilities with equipment, pharmaceuticals, medical supplies, staff, and infrastructure to be able to provide preventive, diagnostic, treatment, and referral services to ensure a comprehensive package is available to all patients. In addition, MA continues to ensure global standards for infection prevention and control procedures at all service delivery sites. Data generated in health facilities are collected in MOH-approved HMIS forms, transmitted through the district, regional to the national level where MA supports the analysis and use for decision-making. All health services are provided free of charge with no discrimination by gender, age, sex, status, or ethnicity.

Health: As a result of the Floods, population displacement, and overcrowding in IDP camps, outbreaks of infectious diseases are common. MA’s response for Emergency floods building on the recently ended MNCH/MDR health response with detection, response to potential outbreaks and provision of health services to affected populations as described in the Humanitarian Response Plan (HRP). Through an integrated approach, MA supports equitable access to emergencies and essential health care services. By integrating services, especially with nutrition and WASH, actions will prevent individuals slipping back into malnourished and fragile health conditions. With the ongoing drought, increase in AWD/cholera outbreaks and deterioration of the nutritional status of children younger than 5 years is frequent. A scale up for detection and case management services for AWD/cholera and those severely malnourished with complications, is being done to save lives. Measles vaccination coverage, estimated below 50% in rural villages, is not enough to prevent measles outbreaks. Susceptibility to communicable diseases such as these is compounded by poor nutrition, low immunization coverage, and limited vector control interventions (Partners SCI Baseline Report 2020).

MA recognizes the need to sustain and further consolidate humanitarian health assistance for IDPs and underserved rural populations and supports the Maternal Newborn and Child Health (MNCH) facilities and Multi-Drug-Resistant Tuberculosis (MDR-TB) hospital through the provision of incentive salary payments of health workers and providing running costs for the

MNCH facilities and MDR-TB hospital. Additionally, Muslim Aid provides capacity building and quality assurance through support supervision and monitoring of health facilities on quarterly basis. Additionally, the MNCH facilities are provided with a monthly essential drug supplies for the treatment of common illness at the facility. The targeted facilities are listed below: -

. PURPOSE

The purpose of the end line evaluation is to assess the overall performance, outcome and impact of the project with an aim of providing realistic and feasible recommendations for improving similar programs in Somalia context. The findings of the end line evaluation will be used as a post-test measurement of changes in the indicators attributable to the program interventions.

2a. SPECIFIC OBJECTIVES

The evaluation objectives also include the following.

1.    To evaluate to what extent the response has fulfilled its objectives and outcomes to improve the health of 147,000 direct in Banadir, Bakool, Lower Shabelle, Hiran, and Lower Juba regions, across 8 MNCHs and 1 MDR-TB Hospital and the technical strength of the program.

2.    Undertake a comparative assessment on the progress achieved in delivering the program results and the targets of the indicators to identify key successes, gaps, and constraints that need to be addressed.

3.    To assess Relevance, efficiency, effectiveness, sustainability, coherence and impact criteria used, and also the protection component of the intervention.

4.     To assess the long term and short-term impact of the actions on the targeted population and document the lessons learnt and provide recommendations for future interventions.

5.    To determine value for money in achieving the best results we can with money and resources available.

6.    To collect the information for the indicators that are required to be collected by the endline evaluation, which is described in the project’s Logframe.

7.    To evaluate/focus on the impact of engaging Traditional Birth Attendants (TBA) during the project Implementation period.

LEARNING QUESTIONS

1.    Objective 1: Evaluate to what extent the response has fulfilled its objectives and outcomes to improve the health of 147,000 direct in Banadir, Bakool, Lower Shabelle, Hiran, and Lower Juba regions, across 8 MNCHs and 1 MDR-TB Hospital and the technical strength of the program.

a.     To what extent were the six objectives of the Minimum Initial Service Package achieved?

b.    How did the interventions effectively achieve its intended outcomes and objectives? What aspects worked well, and which ones did not?

2.    Objective 2: Undertake a comparative assessment on the progress achieved in delivering the program results and the targets of the indicators to identify key successes, gaps, and constraints that need to be addressed

a.     What progress was achieved in delivering the program results?

b.    What are some of the successes achieved by the project?

c.     What are some of the gaps or constraints that need to be addressed?

3.    Objectives 3: Assess relevance, efficiency, effectiveness, sustainability, coherence and impact criteria used, and the protection component of the intervention.

a.     What are possible adjustments for the project that would maximize the project’s efficiency and relevance in the future?

4.    Objective 4: assess the long term and short-term impact of the actions on the targeted population and document the lessons learnt and provide recommendations for future interventions.

a.     What are some of the short-term impacts of the interventions?

b.    What are some of the lessons learnt and recommendations that can be applied in future interventions?

5.    Objective 5: determine value for money in achieving the best results we can with money and resources available.

a.     What is the value for money in achieving the best results?

6.    Objective 6: Collect the information for the indicators that are required to be collected by the endline evaluation

a) Please review project’s Logframe to see the indicators

7.    Objective 7: Evaluate the impact of engaging the TBAs during the Project Implementation period

a)     To understand which group (if any) was the most effective at reaching the community?

b)     How successful was the awareness raising in involving communities in the transformation of their own health and reducing maternal and neonatal morbidity and mortality?

c)     To what extent did it encourage women to deliver in the health facilities?

3. EVALUATION CRITERIA

The following evaluation questions should be at least included in the evaluation criteria. These evaluation criteria are based on OECD DAC.

a)   Relevance

1)   To what extent are the objectives of the programme valid for the country programme and target community?

2)   Are the activities and outputs of the programme consistent with the overall goal and the attainment of its objectives?

3)   Are the activities and outputs of the programme consistent with the intended impacts and effects of its Strategy?

4)  Was the design of the project the most appropriate and relevant to promote the strategy?

b)  Effectiveness

1)   To what extent were the project objectives demonstrating progress on Core indicators?

2)   To what extent did the project achieve the planned objectives and results?

3)    What were the major underlying factors (internal and external) influencing the achievement or non-achievement of the results within the one year of the project implementation?

4)   To what extent was technical input provided to the project team in leading the implementation of plans and proposed activities of the Programme?

5)   What are the major accomplishments of the Programme?

c)  Efficiency

1)   Assess how the activities were cost-efficient within the programmes supported by project?

2)   Does the Project offer better value for money within the rural and urban context in terms of its impact?

3)   Identify the cost factors spent to deliver interventions in the urban and rural community and identify the reasons behind budget underspent

4)   Does the team have adequate human and financial resources? For data collection, and monitoring

d)  Impact

1)  What are the key short term and long-term changes produced by project, positive or negative and what are the key factors behind these changes?

2)    What real difference has the project activities made for the direct, and indirect stakeholders of promoting HEALTH/interventions?

e)  Sustainability

1)  To what extent did the benefits of the projects continue after the fund support is ceased?

2)  What were the major factors which influenced the achievement or non-achievement of sustainability of the project?

g)  Coordination

1)  How have the project activities been coordinated within different stakeholders to achieve overall objective?

h)  Scalability/Replicability

1)  Are there any aspects or components of the project likely to be scaled up or replicated in other programme areas?

2)  Who are the main actors in the scale-up/replication of the approach in other urban and rural locations and how has the project engaged with them to date?

4.1 METHODOLOGY

The lead consultant with the other team members will develop the evaluation methodology in collaboration with Health team and Head of Programs. The lead evaluator or team is expected to write an inception report following review of literature and reference documents using the guidance format provided by MA Somalia.

Such a methodology should define an appropriate sample size and specify mechanisms that will be adopted to avoid selection bias. The lead evaluator will be expected to utilize various data collection tools like questionnaires, key informant interviews guides, FDGs, observation to obtain

data from the various respondents and key stakeholders. As a minimum, the evaluation process will include the following key steps:

1.    Gender balance in respondents or sample size, with a margin of 10% flexibility

2.    Review of relevant literature related to the project (c.f. list of reference materials) and drafting an inception report;( proposal, quarterly reports, monitoring reports, budgets among others)

3.    Data collection to apply-appropriate data collection tools (e.g. questionnaire, checklist etc.) for Interviews and focus group discussion.

4.    Data analysis and Evaluation Report writing, and

5.    Presentation of key evaluation findings.

4.3. REFERENCE MATERIAL

•      Project Technical Proposal(year) 2024

•      MEAL Plan for (year) 2024

•      Performance indicators - Logframe

•      Quarterly reports

•      Monitoring reports

•      Case studies

The evaluation shall be conducted by an external evaluator or evaluation team, selected through a competitive proposal submission process. The following are minimum requirements for the team/consultant to be considered for carrying out the assignment

✓   At least a Master’s degree in project management, Statistics or any other related fields

✓   Minimum of 5 years’ relevant professional experience in conducting evaluations for Health programs

✓   Strong experience in conceptualizing and evaluating MA funded programs preferably in the context of Somalia

✓     Excellent communication and report writing skills.

8.  Person/Consultant specifications

•      Skills in qualitative evaluation design and analysis; Quantitative research skills highly desirable.

•      Knowledge of programming, campaign and policy context for child survival in developing countries.

•      Experience within an international NGO preferably at both country and HQ levels. Strong grasp of internal and external funding mechanisms

•      Strong background in programme monitoring and evaluation

•      Desirable: familiarity with Muslim Aid Somalia organizational structure and culture

All interested applicants are requested to submit their proposals no later than: Tuesday, 17 December 2024, at 5:00 PM [EAT]

Proposals must be submitted via email to: [email protected]

Please ensure the subject line of the email clearly states: Proposal Submission for Endline

Evaluation for Healthcare Program– [Your Organization Name]