Consultancy - Mid Term Review, Better Health for Older People in Africa

1. Background

The Better Health Programme is a three year programme, (July 2014 – June 2017), with a total budget of GBP 3,910,354 that is funded by DFID. The programme is implemented in four countries; namely; Mozambique, Zimbabwe, Tanzania and Ethiopia.

The overall aim of the programme is to make poor older women/men and their households less vulnerable to illness and worsening poverty through provision of better access to health and care services. Age – appropriate health, HIV and care services as well as social entitlements that will better enable them to meet their health needs will be availed. Efforts on improving the accountability of service providers and policy makers both locally and nationally will also be made.

2. Programme Objectives

Impact: Better health and reduced poverty for older men and women

Outcome: 387,763 older people (60% female, 40% male) in four countries in Africa have age –appropriate health and HIV services

Output 1: Training curricula developed and 1,718 health staff trained on age appropriate health and HIV services

Output 2: 1,425 care workers trained and older people receive community and home based care

Output 3: Technical and policy support for greater access to social protection and health entitlement

Output 4: Older people trained to monitor and advocate locally for access to health, HIV and care services and entitlement

Output 5: HIV and social protection policies/strategies in the four countries and within the region include recommendations made by the programme

3. Target Beneficiaries

Direct Beneficiaries – 387,763 older women and men, (232,658F, 155,105M), over 50 years in the programme areas, will access improved health care services (age – friendly and gender sensitive).

1,718 health staff will benefit from the training supported by the programme

Indirect Beneficiaries – Family members, from 938,853 older people households will benefit. This is assuming that one household has five members. Thus, improving the health status of an older person at the household level, will lead to improved livelihood status within the household, making an older person less dependent on the other household members.

4. Programme Management

HelpAge International, is an international network of organizations working on ageing with a London secretariat. HelpAge manages the programme through its country offices and representatives found in each of the programme countries as well as its regional offices and headquarters in London.

Age International is the UK affiliate of the HelpAge Network and has the overall responsibility of overseeing the programme management, reporting and donor liaison. It also has the responsibility of sharing the programme learning widely.

HAI country offices/representatives manage the country programme through working closely with national partners; coordinating with the regional HAI offices, monitoring activities and reporting. Monthly steering group meetings are held involving staff from HelpAge International (regional and London offices) and Age International. Monthly meetings are also held between the Regional Programme Manager and the four country Programme Managers.

Country Offices with Implementing Partners

Mozambique (MOZ) – HelpAge International

Partners

• Associacao Para Aos Velhos Desamparados (AAVEDOS)


• Associacao Crista Interdenominacional para o Desenvolvimento da Comunidade (ACIDECO)


• Associacao de Proteccao dos Idosos de Tet (APITE)


• Associacao Pfuna Swissiwana (APS)


• Red Cross Mozambique (CVM)


• Pro-Idoso (Association in Support of Older People) Associacao Humanitaria de Apoio a Velhice (Vukoxa)

Ethiopia – HelpAge International

Partners

• Ethiopian Elderly and Pensioners National Association (EEPNA)


• Resfa Social and Development Association (TSDA)

Zimbabwe -Centre for Community Development Solutions Trust (CCDS)

Tanzania – HelpAge International

Partners

• Jumuiya Wastaafu Na Wazee Zanzibar (JUWAZA)


• Magu Poverty Focus on Older People Rehabilitation Centre (MAPERECE)


• Tanzania Mission to the Poor and Disabled (PADI)

5. Objectives of the Mid – Term Review

i. To test the extent to which the programme is realizing its broader theory of change

a. To critically assess the current level of achievement vis – a- vis the initial plan and the effectiveness, efficiency, relevance and the likelihood of impacts.

b. To assess the sustainability of the implementation procedures, approaches and modalities; as well as the level of synergies, integration, and coordination issues

c. To give recommendations for changes based on the assessment findings to improve the implementation over the final phase of the programme

d. To identify learning, intended or unintended, as a result of implementation of the programme and utilization of the results for informed decision making.

e. To identify the challenges/gaps encountered and solutions given to resolve them – and where possible combine them with action – oriented and specific recommendations that can be taken forward

6. Issues to be Analyzed/Assessed

The mid – term review shall verify, analyze and assess in detail the issues and questions outlined below:

i.Relevance

a. The extent to which the objectives of the project are consistent with the target beneficiaries’ needs/priorities

b. The extent to which the project design is consistent with the individual implementing country contexts

c. The quality of the problem analysis and the project’s intervention logic, appropriateness of the indicators, analysis of assumptions and risks

d. The degree of flexibility/adaptability to changes in circumstances

e. The realism in the choice and quantity of inputs (financial, human and administrative resources)

f. The appropriateness of the recommended monitoring and evaluation arrangements

ii.Efficiency

How well the programme activities have transformed available resources into the intended results/outputs, in terms of quantity, quality and timeliness will be assessed.

a. To what extent are activities implemented as scheduled, and how economically were resources/inputs (funds, expertise, time), converted to results

b. How regularly and well are activities monitored by the project and corrective measures applied as necessary?

i. The quality of monitoring, accuracy of findings and the use made of the information acquired; adequacy of the baseline information

iii.Effectiveness

How far the programme results to date were attained and the outputs achieved will be assessed:

a. What monitoring and evaluation systems are in place and how effective are they

b. What systems are in place for lessons learning and how it is replicated within country offices and regionally

c. How well is the project maximizing synergies with other HelpAge projects in country and in the region

d. Older people and other stakeholders’ participation in the design and in the planning management/implementation/monitoring of the project, the level of local ownership, absorption and implementation capacity.

· The roles and responsibilities fulfilled by all implementing partners at country levels. How the performance of each agency influenced the realization of project objectives.

· How appropriate were the implementation modalities, communication and management structures within and amongst Age UK, HelpAge London and HelpAge Country offices, the Beneficiary and its implementing partners

iv.Sustainability

The level of which the programme’s positive outcomes and the flow of benefits are likely to continue after the programme has phased out, in terms of the following:

a. Policy Support – prospect of current efforts/contributions by the programme of influencing policies/strategies at country and regional level

Institutional Capacity – how far the programme is embedded in the local institutional structures – if the health facilities retain the knowledge received after trainings – if OCM will actively continue working after the programme has phased out – What changes have occurred in the capacities of local implementing partner organizations that will enable them to continue supporting the work after the programme has phased?

b. Socio – cultural factors – whether the project is in tune with local perceptions of needs and of ways of producing and sharing benefits; whether it respects local power structures, status systems and beliefs, and if it sought to change any of those, how well accepted are the changes both by the target group and by others

c. Financial sustainability – whether the services being provided are affordable for the intended beneficiaries and are likely to remain so after the funding has stopped

v. Cross – Cutting Issues

a. What measures have been taken to mainstream gender in the programme and to what extent have women and vulnerable groups been involved in decision making

vi. Value Added

a. To what extent the programme objectives, targeted beneficiaries, timing etc. is complementary and coordinated as well as creating actual synergy (or duplication) with similar ongoing interventions within HelpAge, implementing countries and within the region

b. How well is sharing and learning practiced internally and with other like-minded actors

7. Methodology

A consultant will be recruited with the vacancy announced publicly. After the consultant has been contractually engaged the review process will be carried out through the following phases:

a) Desk Review

Programme documents such as project proposal, log frame, budget, reports, baseline report, internal monitoring reports, contractual agreements with partners and local/in country government bodies will be reviewed. Documents shaping the wider external environment such as in country policies, strategies employed by regional bodies will be reviewed. This will be done in order to see the overall picture in which the project is functioning and how far it has achieved its objectives; to be later triangulated through data collected from field work

On the basis of the information collected the consultant should:

• Comment on the review questions suggested in section 6, propose an alternative or complementary set of review questions and justify their relevance.


• Develop detailed data collection tools and sub questions. Present a methodology to the overall assessment of the programme and present the list of tools to be applied in the field phase.


• Propose the work plan


• At the end of the desk review the consultant should prepare and submit an inception report to be discussed and approved by HelpAge

b) Field Exercise

The field exercise will start upon approval of the inception report submitted by the consultant to HelpAge and will be used to triangulate information received from the desk review. The field exercise will include:

• Field visits to two of the four countries – selection will be based on criteria developed with consultants; (one country from both eastern and southern Africa will be selected)


• The team of consultants will be visiting the selected countries and collecting data together with the country teams


• Field visits within selected countries will be based on purposive sampling depending on the context at hand


• Interviews with stakeholders/focus groups; interviews with HAI and partner staff, MOH staff and other stakeholders will be undertaken in accordance with the sampling methodology

c) Analysis/Reporting

Information collected will be analyzed by the consultant and preliminary report will be submitted to HelpAge. The consultant has to make sure that the assessments are objective and balanced, affirmations accurate and verifiable and recommendations realistic.

Based on the he final report, HelpAge International will provide a management response and will develop an action plan to follow up recommendations provided by the evaluation team.

On the basis of the comments received the consultant has to amend and revise the draft report accordingly or sound justifications must be provided for issues the consultant believes not to be changed.

The final evaluation report which includes the key attributes explained above, key challenges identified, key lessons emerging form the project, recommendations and clear set of conclusions will be shared with all relevant staff in HelpAge and Age International. The final report will include:

• Executive Summary– no more than 2 pages – focusing only on key issues including the project progress and clearly indicating the main conclusions, lessons learned and specific recommendations.


• Key Findings/Main text – no more than 25 pages – the main text should start with an introduction describing all relevant background information in relation to the project intervention and mid – term review objectives. It will describe the methodologies used and main findings


• Conclusions and Recommendations – no more than 7 pages – wherever possible for each key conclusion there should be a corresponding recommendation


• Annexes– any supporting document used for the evaluation will be included in the annex

8. Consultant Qualification

Interested applicants should have the following:

• PhD or a Master degree in public health, international development


• Strong M&E background with experience of evaluating multi country programmes


• Have experience in planning, implementing and reviewing/evaluating health related programmes


• Have experience in undertaking review of DFID funded programmes


• Be well acquainted with cross cutting issues such as gender


• Knowledge of Kiswahili, Portuguese and Shona is a plus

9. Assignment Duration

The mid-term review will commence from October 19 to December 2, 2016, totaling 45 days including the preparation and submission of the final report.

10.Tax Liability

Settlement of any tax liability arising from this agreement will remain the responsibility of the consultant