TERMS OF REFERENCE
“Policy Brief on the Universal Progressive Home Visiting program (UPHV)”
There have been advances in healthcare provision in Kosovo in recent years, with improvements in the health outcomes of mothers and children, but yet much remains to be done to improve the maternal health and the child health outcomes.
In its efforts to address the observed inequalities, Ministry of Health with the support of UNICEF started the Universal Progressive Home Visiting (UPHV) program, based on integrated child health development and wellbeing approach, in complementary to improved facility-based practice, and builds capacities for the program maintenance. Since 2019, this program is being implemented by Action for Mothers and Children.
UPHV packages are designed and target families by visits from the pregnancy through the first three years of life and additional visits to be made based on identified needs of eligible families. UPHV help families identify newborn problems, including signs of illness and at the same time support the practices of breastfeeding, vaccinations, and contribute to the child’s growth and development in order to achieve the full potential of the child. UPHV’s overall goal is to increase the knowledge of medical staff, pregnant women and new mothers in antenatal care, postpartum care, postnatal depression, early childhood development (0-3 years), the role of partners and other family members to provide support, expansion and empowerment of healthcare providers across Kosovo through training programs and engagement in educational activities.
Currently, the UPHV program is being implemented in 22 municipalities in Kosovo and will soon expand in the whole territory of the country. Since the beginning of the program, 498 healthcare providers have been trained. During 2019, more than 16 000 home visits were conducted and around 8500 pregnant women and 2000 children benefited from these visits. Due to the pandemic COVID-19 we have not been able to conduct home visits physically since March 2020, but instead we have conducted the visits via telephone. Up to date, 9695 children and 1752 pregnant women have benefited from the program during 2020.
Findings from the UPHV program evaluation conducted in the end of 2019 show that there is low coverage of children reached, especially among Roma, Ashkali and Egyptian communities in Kosovo. In this regard, the report recommends four key areas for future consideration and action:
- Model of Service Provision, testing one doctor and two nurses model for achievement of UPHV aspirations to timely detect developmental delays and risks;
- Management for Results which would require demand and accountability for achieving set targets for HV that have to be established.
- Money and resources, meaning incentives for home visits and also for creating more conducive working environment for home visitors (support with transportation and means of communication along with the necessary equipment/bags for home visitors)
- Knowledge, Skills & Tool which include pushing knowledge and performance boundaries of nurses beyond medicalized approach and supporting service provision with the digitalized home visitor checklists and other tools for service standardization
In order to increase the coverage of the UPHV program in the implementing municipalities, a review of the UPHV model which examines the impact, relevance, effectiveness, efficiency and sustainability is needed.
Within this context, Action for Mothers and Children is seeking the support of a national consultant or a team of national consultants to review the model of the UPHV and develop a Policy Brief with key findings and recommendations.
II. PURPOSE of the ASSIGNMENT
The overall goal of the policy brief is to inform policy makers on how to improve the implementation of the UPHV program in Kosovo. The purpose of the assignment is to the factors that so far have affected the results of the program in different municipalities of Kosovo, comparing them and assessing which were the mitigating and which the hindering factors in the municipalities that had the best and worst results. The consultant/s will be focused in four municipalities: Gjakova, Dragash, Gjilan and Lipjan, comparing these municipalities and analyzing the difference based on UPHV program results of medical staff who are engaged only in UPHV program, and those engaged in the UPHV and conduct other duties in the respective institution as well.
Based on the above-mentioned analysis, the document will list concrete recommendations dedicated to stakeholders involved in the implementation of this program.
The development of the policy brief will be based on:
- Primary qualitative data collection: data generated from focus groups with the target group and in-depth interviews with key stakeholders - medical staff and state institutions involved in the program;
- Secondary analysis: data generated from analysis of the findings of the evaluation report “Multi-Country Evaluation of the Universal Progressive Home Visiting for Young Children Well-being and Development in the Europe and Central Asia Region (ECAR) in the period of 2014-2018: Kosovo* Case Study” and data generated from the UPHV programme itself;
This policy brief will serve: 1. As an evidence piece that will inform the management and medical staff involved in the program; 2. To identify what are the opportunities and models of service provision to increase the coverage of children and pregnant women provided with such services; and 3. As an advocacy tool for decision-makers with concrete recommendations aiming at advancing the program.
III. SCOPE OF WORK AND TENTATIVE WORK CALENDAR
The consultant(s) is/are expected to complete the following tasks and submit deliverables in line with the work calendar below:
- Develop the inception report including desk review of UPHV related materials, focus groups, in depth-interviews, etc.
- Organize and collect primary qualitative data from focus groups and in-depth-interviews;
- Analyze and generate findings and recommendations from the focus groups and in-depth interviews;
- Revise secondary information from the UPHV programme, the evaluation report “Multi-Country Evaluation of the Universal Progressive Home Visiting for Young Children Well-being and Development in the Europe and Central Asia Region (ECAR) in the period of 2014-2018: Kosovo* Case Study” and other UPHV related reports and materials;
- Develop the policy brief on the UPHV programme;
- Present the policy brief findings and recommendations to the roundtable and validate the document with stakeholders.
TASK | DELIVERABLE | ESTIMATED WORKLOAD (Person/Days) | DELIVERY DATE
1 | Inception meeting with UNICEF and AMC | Meeting minutes and action points (via e-mail) | 1 day | November 2020
2 | Develop the inception report including desk review of UPHV related materials, focus groups, in depth-interviews, etc. | Inception report | 1 day | November 2020
3 | Organize and collect primary qualitative data from focus groups and in-depth-interviews | Focus group minutes/ Findings report / Indepth-interviews minutes | 10 days | November 2020
4 | Revise secondary information from the UPHV programme, the evaluation report “Multi-Country Evaluation of the Universal Progressive Home Visiting for Young Children Well-being and Development in the Europe and Central Asia Region (ECAR) in the period of 2014-2018: Kosovo* Case Study” and other UPHV related reports and materials Report on findings | 7 days | November 2020
5 | Develop the policy brief on the UPHV programme | Policy brief document | 7 days | December 2020
6 | Present the policy brief findings and recommendations to the roundtable and validate the document with stakeholders | PPT presentation | 1 day | December 2020
Action for Mothers and Children
V. PROFESSIONAL QUALIFICATIONS
Competencies required to carry out the tasks are as per below:
- Masters degree and/or certifications in relevant fields (Medicine, Public Health, Social Sciences, or similar) is a requirement;
- At least 4 years of experience in conducting research and good analytical skills;
- Experience in developing policy briefs, reports, and similar documents in the field of health;
- Excellent oral and written English language;
- Relevant experience in working with the UN agencies in Kosovo or other countries is an
VI. DURATION, LOCATION, COSTS AND PAYMENT SCHEDULE
The assignment will cover an estimate of 27 days (from November to December 2020) and payments will be affected upon the delivery of outputs. In case of any unexpected delay in the estimated time frame (approval process, force majeure etc.) the duration of the assignment might be extended subject to the same conditions and mutual will of the parties.
The selected consultant(s) is/are expected to complete all tasks and deliverables in line with the “Scope of Work and Tentative Work Calendar” section of this ToR. The contract will be effective from the date of signature until successful completion of services outlined in this ToR.
In principle, this is a desk-based consultancy. If needed, meetings will be based in Prishtina and/or will be conducted on-line.
Estimated Cost of Consultancy: Applicants shall present a detailed financial proposal that elaborates daily costs on the basis of the above-mentioned programme and deliverables, including a total sum demanded.
All costs, including travel, accommodation, administrative tools, communications, etc. shall be covered by the consultant and should be included in the financial proposal as a separate heading, and broken down into details of accommodation and travel costs.
Payment schedule: AMC will issue a contract in EURO. The payment will be done in installments upon deliverables as per contractual agreement and will be executed in EURO.
Candidates are required to specify their daily rates and the total amount as per the number of anticipated working days for each deliverable in the financial proposal and provide the breakdown of the lump sum amount for each deliverable as well as incidentals of each deliverable in EURO. It is up to the team how to divide number of working days within the team.
VII. APPLICATION PROCESS
Applications should be submitted in English and should include:
- Financial proposal
- Examples of analytical work conducted in the past
Application and financial proposals should be sent to firstname.lastname@example.org by 30th October 2020. After the technical evaluation, the financial proposals of qualified candidates will be evaluated.