Consultancy for Performance and Effectiveness Evaluation of iCCM/iCCM+ Implementation in Somalia

TERMS OF REFERENCE
Performance and Effectiveness Evaluation of iCCM/iCCM+
Implementation in Trócaire-Supported Districts, Somalia
1. Background and Context
Integrated Community Case Management (iCCM/iCCM+) is a community-based strategy designed to improve
access to essential child health services for children under five, particularly in fragile and hard-to-reach
settings. Through trained Community Health Workers (CHWs), iCCM addresses common childhood illnesses
including pneumonia, diarrhoea, malaria, and uncomplicated acute malnutrition.
Somalia continues to face high under-five mortality driven by preventable and treatable conditions. Chronic
insecurity, displacement, food insecurity, climatic shocks, and limited access to functional health services
further constrain service delivery in rural and underserved areas.
Trócaire Somalia implements iCCM/iCCM+ across Luuq, Dollow, Belet-Hawa, Ceelwaaq, Garbahaarey, and
Kismayo through trained CHWs linked to supported health facilities. The intervention aims to:
• Improve equitable access to timely treatment
• Strengthen referral pathways
• Improve quality of care at community level
• Contribute to reductions in preventable child morbidity
As the programme matures and integration with nutrition and facility-based services deepens, Trócaire seeks
to conduct a structured performance and effectiveness evaluation to generate actionable evidence for
adaptive programming, donor engagement, and policy dialogue.
Purpose and Objectives
2.1 Overall Purpose
To assess the performance, effectiveness, quality, and integration of iCCM/iCCM+ implementation in Trócairesupported districts and generate practical recommendations for programme strengthening and sustainability.
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2.2 Specific Objectives
The evaluation will:
• Assess service utilisation trends and treatment coverage at the community level.
• Evaluate the quality of service delivery by CHWs, including adherence to protocols and referral
practices.
• Examine the effectiveness of referral pathways between CHWs and health facilities.
• Assess integration between iCCM and nutrition programming (including CMAM linkages).
• Conduct a rapid assessment of data quality within routine monitoring systems (including DDS where
applicable).
• Identify implementation enablers, bottlenecks, and contextual constraints.
• Capture community perceptions, trust, satisfaction, and acceptability of services.
• Provide actionable recommendations for programme improvement, scale-up, and sustainability.
3. Key Evaluation Questions
The evaluation will address, but not be limited to, the following:
To what extent has iCCM improved access to essential child health services in supported districts?
i. How effective and timely is case management delivered by CHWs?
ii. What is the quality of referral systems and linkages to facility-based services?
iii. How well integrated is iCCM with nutrition programming and broader health system strengthening
efforts?
iv. What are the key operational challenges affecting performance?
v. How sustainable is the current implementation model?
vi. How equitable and gender-sensitive is service access and delivery?
4. Scope of Work
The consultant/team will:
1) Review programme design, logframes, and implementation approaches.
2) Analyse routine monitoring data (including DDS and CHW registers).
3) Conduct a rapid data quality assessment of routine monitoring systems.
4) Undertake mixed-methods data collection in selected representative districts.
5) Assess integration between iCCM and nutrition services, including referral and data linkages.
6) Review supervision mechanisms and CHW support structures.
7) Examine cross-cutting priorities including gender, equity, AAP, protection, and conflict sensitivity.
8) Document best practices, innovations, and lessons learned.
5. Geographic Coverage
Trócaire Somalia currently implements iCCM/iCCM+ in the following districts:
Luuq, Dollow, Belet-Hawa, Ceelwaaq, Garbahaarey, and Kismayo.
The evaluation will not cover all implementation districts. Instead, data collection will be conducted in a
purposively selected sample of representative sites drawn from the above districts. Site selection will ensure
variation in operational context, accessibility, performance levels, and programme maturity in order to
generate meaningful and transferable findings.
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The final sampling strategy and geographic coverage will be agreed upon during the inception phase, based on
methodological considerations, feasibility within the eight-week timeframe, and data availability.
6. Methodology
The consultant is expected to propose a robust mixed-methods approach, including:
• Desk review of programme documentation
• Quantitative analysis of routine monitoring and service utilisation data
• Structured caregiver interviews or limited household surveys (sampling to be defined)
• Focus Group Discussions (FGDs)
• Key Informant Interviews (KIIs) with CHWs, supervisors, facility staff, and health authorities
• Limited structured observation of CHW service delivery (where feasible)
The consultant will define sampling approaches in the Inception Report.
7. Ethical Considerations
The evaluation must adhere to:
i. Informed consent procedures
ii. Confidentiality and data protection requirements
iii. Child safeguarding standards
iv. Ethical and evaluation practices in fragile settings
8. Duration and Timeline
The assignment will commence in March 2026 and run for eight weeks.
Indicative Phases:
• Inception and desk review (Week 1–2)
• Tool development and validation
• Data collection (Week 3–5)
• Data analysis and synthesis (Week 6–7)
• Reporting and validation workshop (Week 8)
9. Expected Deliverables
1) Inception Report (including refined methodology, sampling strategy, tools, and workplan)
2) Cleaned quantitative dataset and analysed qualitative transcripts
3) Draft Performance and Effectiveness Evaluation Report
4) Final Evaluation Report incorporating feedback
5) Executive Summary Brief (2–3 pages) tailored for donor dissemination
6) 3–5 human-interest case studies illustrating programme impact
7) Presentation of findings to Trócaire programme team
All deliverables must be submitted in English and in editable formats.
10. Management and Reporting
The consultant will report to the Head of Programmes, Trócaire Somalia.
Technical oversight will be provided by the Health & Nutrition team, with coordination support from
Monitoring, Evaluation, Accountability and Learning Team.
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A validation session will be conducted prior to final report submission.

11. Consultant Qualifications
• Master’s degree or higher in Public Health, Epidemiology, Health Systems, Social Sciences, or related
field.
• Minimum 7–10 years of experience in public health programme evaluations in humanitarian or fragile
contexts.
• Demonstrated expertise in iCCM, MNCH, child health, or primary health care.
• Strong mixed-methods evaluation experience.
• Experience in Somalia or similar fragile contexts strongly preferred.
• Familiarity with routine health information systems and digital monitoring platforms.
• Demonstrated ability to translate evidence into practical programme recommendations.

12. Application Requirements
Applicants must submit:
1) Technical proposal outlining methodology and workplan
2) Financial proposal (detailed)
3) Updated CV(s)
4) At least two samples of similar evaluation work

Submission of Proposals
Your proposal, marked “SOM-ECHO-HEALTH-2026-1014 – Consultancy for Performance and Effectiveness
Evaluation of iCCM/iCCM+ Implementation in Somalia”, must be submitted by email to
[email protected] no later than 12th of March 2026, 05:00PM EAT.
Proposals should be submitted in two separate PDF files - one clearly labelled Technical Proposal and the
other Financial Proposal. Late or incomplete submissions will not be considered.
Shortlisted applicants may be invited to a presentation with the Tender Evaluation Committee to highlight key
aspects of their proposal and respond to clarifications