EVALUATION OPPORTUNITY!!!  EVALUATION OPPORTUNITY!!!

The Anglican Diocesan Development and Relief Organization (ADDRO) is a registered non-profit, non-governmental organization that seeks to transform life and uphold human dignity and justice for all people, irrespective of ethnicity, sex, religious or political affiliations. It seeks to appoint suitable and qualified persons to evaluate two of its community intervention programmes, namely Food Security and Livelihood Programme and Integrated Community Based Health Programme.

  1. TERMS OF REFERENCE END-OF-PROGRAMME EVALUATION OF THE FOOD SECURITY AND LIVELIHOOD PROGRAMMEME

1.0 INTRODUCTION

The Anglican Diocesan Development and Relief Organization (ADDRO) with funding from Episcopal Relief and Development has been implementing a Food security and livelihood support programme (FSLP) in the Upper East Region of Ghana since 2006. In 2016 ADDRO introduced Savings with Education (SwE) as part of the Food security and livelihood programme. This end of programme evaluation is for the FSL program implemented from 2013-2017.

ADDRO, the implementer of this project, is a registered church based non-profit non-governmental organization that seeks to transform life, uphold human dignity and justice for all people irrespective of tribe, sex, religious or political affiliations. Over the years, ADDRO has strived to create a holistic impact on communities through its development programs on the following thematic areas; Agriculture and Sustainable livelihood, Health, Education and Advocacy, Environment, Governance and Peace building, Disaster and Relief and Capacity development.

This TOR seeks to evaluate the Food Security and Livelihood program to compare with the baseline survey and midterm evaluation that was conducted.

2.0 BACKGROUND

The three regions in northern Ghana are the poorest in the country. The Ghana Living Standards Surveys 2010 and other agricultural reviews indicate that the most food insecure and economically vulnerable households live in these three regions of the country.

Food availability in the programme area is limited, which can be attributed to a number of factors including; inefficient farming practices, lack of appropriate technology tools and equipment for storing and processing of farm products, inadequate access to critical inputs such as fertilizers and improved seed that would increase yield, poor soil fertility and unreliable rainfall and a climate that supports only one rain-fed growing season per year. The situation is further limited by low income levels, lack of market linkages and poor supporting infrastructure such as credit facilities, irrigation systems, roads and public transportation, electricity and communication networks.

Principle concerns in northern Ghana therefore is anchored on poverty, which is most severe among food crop farmers, who are mainly traditional small-scale poor farmers of which many are women. Women, despite being over burdened by domestic chores, are responsible for about 60 percent of agricultural production. Consequently, the effects of poverty on women and children are great. Hardship and the stress of managing poverty among women leads to poor health and low morale resulting in a feeling of guilt and shame, lack of control, and widespread of depression among mothers, which can undermine mothers/caregivers capacity to perform an effective parenting role.

To cope with food shortages and manage other sources of livelihoods (including low incomes) among women in their households, they resort to felling of trees for fuel wood, charcoal burning and the traditional hunting exercise. These activities in support of their livelihoods needs contribute the destruction of the environment and loss of biodiversity which further aggravates poverty in these communities.

It is widely accepted that the poor have tremendous capacity to help themselves out of poverty if only they get the needed support. The availability of credit is key to this: if people can generate sufficient income from their businesses they can repay credit and reinvest the remainder.  Experience of ADDRO in this and elsewhere has shown that credit programmes targeted specifically for the poor entrepreneurs and especially for women can have a marked effect on improving the incomes and living standards of rural people. To this end, ADDRO in partnership with Episcopal Relief & Development seeks to contribute to improving food security and income levels of rural farm families and this has a deeper significance for the overall poverty reduction.

3.0 OBJECTIVES OF THE PROGRAMMEME

  1. To increase crop yield and improve animal management by 2017
  2. To improve household food security through supporting agro-processing and improving effectiveness of crop storage by 2017
  3. To improve long-term household food security through sustainable management of natural resources
  4. To improve small and medium businesses by providing support to entrepreneurs

4.0 PROGRAMME IMPLEMENTATION STRATEGY

The Anglican Diocesan Development and Relief Organization (ADDRO) integrated Food Security and Livelihood Support Programme seeks to meet the agricultural and livelihood needs of poor people in northern Ghana. While the savings with education program, a savings-led microfinance program, seeks to provide basic financial services to the very poor and those living in rural communities especially women.

To this end, the programme has adopted an integrated strategy to increase agricultural production and productivity and income of beneficiaries.

In this context, training of farmers and community volunteers, business education and entrepreneurship training for microcredit recipients, are key implementation strategies. Other implementation strategies include training workshops in both technical skills and in some subject areas such as group formation and dynamics, credit and business management, records-keeping, and promotion and marketing skills. The training component of the project seeks to build the capacity of the different beneficiary groups in their activities.

Other specific strategies include the following:

  • Support farmers (women and men) with improved varieties of seed and technologies that will facilitate increased production and yields of farmers.
  • Support farmers to improve their storage through construction of household silos
  • Provide basic equipment to facilitate agro-processing
  • Carrying out community durbars on the importance of bush fire prevention, controlled burning, and contour ploughing
  • Empowering farmers with improved breeding stock of goats & sheep
  • Support for micro entrepreneurs with micro credit to increase their access to production capital.
  • Supporting farmers with various seed (groundnuts, soya, shea and rice) to process into food products
  • Establish links with Ministry of Agriculture (MoFA) for veterinary services
  • Provide incentives for Community Extension Volunteers
  • Form and support saving with Education groups

   5.0 EXPECTED PROGRAMMEME OUTCOMES

  1. Increase in farmers adopting 4 out of 7 improved farming practices.
  2. Increase in farmers’ yield for chosen crop(s)
  3. Increase in animals owned by farmers (goats, sheep and pigs)
  4. Increase in level of production of processors
  5. Increase in income of participating processors
  6. Increase in the improved agro-processing and storage practices
  7. Increase in knowledge of good post-harvest practices (handling and disinfecting of targeted crops)
  8. Reduction in number of farmers practicing burning
  9. Increase in micro-entrepreneurs engaged in income generating venture
  10. Increase in micro-entrepreneurs who are able to increase the size of their business operations and income levels
  11. To increase the income levels of savings with education groups

6.0 THE TERMS OF REFERENCE

6.1 Purpose of the Evaluation

The Purpose of this End-of-Programme Evaluation is to assess the outcome performance, and identify early impact as well as lessons learnt to inform decisions and practices of the organization for further development of the project or guidance of similar projects in future. To this end, the evaluation should generate knowledge about what does and does not work in the field and why, and to have that knowledge to shape the organization’s policy and practice.

6.2 Objectives of the Evaluation

The objectives include:

  1. To assess the performance of the project with regards to its set objectives, indicators/outcomes
  2. To assess the effectiveness and efficiency of the project activities in achieving those outcomes
  3. To assess the extent, the program might have contributed to long-term effect on the beneficiaries.
  4. To identify lessons learned, gaps if any and make recommendations for future consideration for the audience of this evaluation.

7.0   KEY EVALUATION QUESTIONS

The End of Programme Evaluation will answer the following broad and specific questions

  • Broad questions
  1. What is the value of the program intervention in relation to national Food Security and Livelihood priorities?
  2. What progress towards the stated outcomes and outputs has been made?
  3. What factors have contributed to achieving or not achieving the intended outcomes
  4. What factors contributed to the effectiveness or ineffectiveness of the program?
  5. To what extent has the program responded to priority Food Security issues
  6. What are the major factors that are critical to expand or scale up the Food Security and Livelihood Programme?
  7. What is the effect of the savings with education programme on group members’ access to credit and income levels?

Specific questions

 The evaluator will determine among the programme participants the outcomes for the following indicators. Specific research questions of this evaluation include:

  1. Are more farmers using best practices being taught them? : % of participating farmers each adopting at least five of the following improved practices: 1. correct chemical fertilizer application 2. Crop rotation 3. Integrated crop and pest management 4. Correct crop planting and spacing 5. Compost production and use 6. Improved storage and post-harvest handling of crops. 7. Agro chemical use and handling 8. Tillage practices where appropriate, 9. Construction of contour bunds where applicable
  2. Are more farmers caring for their land in a sustainable way?: Decrease in % of farmers who burn bush to control weeds
  3. Are more farmers using the post-harvest best practices being taught them? : % of farmers using good post-harvest practices such as: 1. harvesting at the right time 2. Separating good produce from bad 3. Use of chemicals appropriately in storage
  4. Are more food processing participants using the food processing and storage best practices being taught them? : % of processors who use improved agro-processing and storage practices such as: 1. Quality improvement-removing/reducing foreign materials; stones, debris etc. 2. Improving appearance-colour, 3. Use of improved equipment 4. improving/maintaining nutritional value of produce
  5. Are processors increasing the quantity of commodity they process a month? Quantity of commodity (Rice Shea nuts, groundnut) processors process a month in kgs
  6. Are income levels of processors increasing? Level of income in Ghana cedis generated from the businesses of participating processors
  7. Are the entrepreneurs who are accessing micro-credit achieving their goals? : % of micro-credit clients who are able to achieve their stated business goal
  8. Are the entrepreneurs who are accessing micro-credit or processing food increasing their income? Proportion of clients who reported an increase in business income
  9. Are women’s rights and access to land changed? # of beneficiary women having access to productive lands
  10. Are farmers’ possession of improved breeding stock of goats and sheep increasing? # of improved animals each farmer is rearing
  11. Are farmers receiving support from community extension volunteers? # of trained and functional community volunteers available
  • SCOPE OF THE EVALUATION

The programme operates in five Districts of the Upper East Region; namely Bawku West, Bongo, Bolgatanga, Talensi and Nabdam. The programme worked with four main categories of participants. They are; Crop farmers, Small ruminant rearing groups, Agro-processors, Micro-Credit entrepreneurs, Saving with Education groups, community opinion leaders and community volunteers.

Each year the programme targets new beneficiary groups as indicated in the table below. All these are within the primary targets for this evaluation. Besides, ADDRO staff are also within the evaluation scope to provide clarifying information and documentations when the need arises in the course of the evaluation

Table 1: Number of new participants for each of the year

No Programme Participant group Number of  participants / Year one (2013) Number of  participants / Year two (2014) Number of  participants / Year three (2015) Number of  participant/Year four (2016) Number of  participants/Year five (2017) Total
1 Crop farmers 300 195 250 200 250 1195
2 Small Ruminant and Pig rearers 120 120 120 120 120 600
3 Agro- processers 118 116 90 70 75 469
4 Micro- credit clients 90 31 63 85 45 314
5 SwE group members 740 411 1,151

B. TERMS OF REFERENCE FOR END-OF-PROGRAMME EVALUATION OF THE INTEGRATED COMMUNITY BASED HEALTH PROGRAMME

1.0 INTRODUCTION

The Anglican Diocesan Development and Relief Organization (ADDRO) is a registered church based non-profit non-governmental organization that seeks to transform life, uphold human dignity and justice for all people irrespective of tribe, sex, religious or political affiliations. Over the years, ADDRO has strived to create a holistic impact on communities through its development programs on the following thematic areas; Agriculture and Sustainable livelihood, Health, Education and Advocacy, Environment, Governance and Peace building, Disaster and Relief and Capacity development.

ADDRO in partnership with Episcopal Relief & Development, USA, has been implementing an integrated community health programme in three regions of Ghana namely Northern, Upper East and Upper West since 2006. In 2009 the programme expanded to include three regions in the southern part of Ghana, namely, Ashanti, Western and Eastern Regions.

From 2006 to 2012, the programme focused on malaria prevention and control and in 2013 it expanded to include HIV&AIDS, TB, and Hep B. ADDRO has been implementing integrated Community Case management (iCCM) with focus on malaria, diarrhoea and pneumonia prevention and management among children under five years, pregnant women and women of reproductive age in the three northern regions and Ashanti, Western and Eastern Regions since 2014.

The iCCM program operates in eight (8) sub-districts in Ghana. These subdistricts are located in the following districts and regions: Bawku West and Builsa North in Upper East region, Karaga in the Northern region, Nadowli in the Upper West region, Bosome Freho in the Ashanti region, Akwapim South in the Eastern region and, Anyinabrim and Abrabra in Sefwi Wiawso in the Western region of Ghana.

The Integrated Community Case Management program falls within the Organization’s health thematic area. A baseline survey was conducted in 2015 prior to the roll out of the iCCM program. This TOR seeks to evaluate the iCCM program in the three years of its implementation.

In 2016, ADDRO introduced Savings with Education (SwE) as part of their Integrated Community-based Health program.

2.0 BACKGROUND

Globally, malaria, diarrhoea and pneumonia account for 7%, 11% and 18% of deaths in children below five years respectively (CHERG, 2012). Pneumonia and diarrhoea are two of the leading killers of young children. Of the estimated 6.3 million deaths among children under 5 years of age in 2013, approximately 15% were caused by pneumonia and 9% by diarrhoea (Arch Dis Child, 2015).

In Ghana, despite successive governments’ health reforms and the enormous strides made in the past decade to improve the health status of the people, communicable diseases continue to challenge public health. Among the communicable diseases, Diarrhoea, malaria and pneumonia are the leading causes of child mortality in the country. Malaria, which is preventable and treatable still remains a major cause of morbidity and mortality. According to the National Development Planning Commission’s (NDPC) Ghana Millennium Development Goals (MDGs) 2015 report, under-five malaria case fatality rate rose from 1.3% to 2.8% in 2011, and dropped substantially to 0.6% in 2012. Although the under-5 mortality rate has been declining in the last two decades, yet one out of every thirteen Ghanaian children still dies before the age of five of malaria. Children under five mortalities is estimated at 78 per 1000 live births (UNICEF, 2012) while infant and neonatal mortality are reported to be 50 and 27 per 1000 live births respectively (GSS et al., 2009).  Pneumonia rate among children under five years old is also high with an annual death of 4,300 children and 72,000 cases, though it is a vaccine preventable disease (GNA, 2012). Despite existing diarrhoea preventable vaccines, the disease still affects many children in Ghana. In 2011, the total number of diarrhoea cases among children under five years was 113,786 out of which 2,318 were with severe dehydration and 354 deaths (GHS 2011 Annual Report).

The impact of malaria, diarrhoea and pneumonia take their toll not only on lives lost, but also directly contributing to poverty and low productivity – many families spend their little incomes/resources in seeking health care as well as not being able work due to these diseases.

It is for these reasons that the Anglican Diocesan Development and Relief Organization adopted the integrated community case management (iCCM) programme to promote timely and low-cost life-saving interventions for these illnesses at the community level.

3.0 OBJECTIVES OF THE PROGRAM

The program seeks to achieve the following specific objectives;

  1. Increase mothers’/primary caregivers’ knowledge and practice of key behaviours in health promotion, disease prevention, appropriate home care, and healthcare seeking for malaria, diarrhoea, and pneumonia.
  2. Increase access to and use of quality health care in rural areas for mothers, children, and their families.

4.0 EXPECTED PROGRAMME OUTCOMES

  1. Community Based Agents and community leaders are trained and equipped in behaviour change communication and participatory methods of health education to work with primary caregivers, families and groups
  2. Mothers and primary caregivers of children (A) Know and practice key health promotion and prevention behaviours; (B) know when and where to seek for early health services
  3. Mothers and primary caregivers of children (A) know the signs & symptoms of malaria, diarrhoea and pneumonia, (B) practice appropriate home care and (C) seek health services when needed
  4. Increase knowledge, skills and supplies of Community Based Agents in integrated community case management to provide basic diagnostic, treatment and referral services at the household and community level.
  5. To increase the income levels of savings with education groups

5.0 PROGRAM IMPLEMENTATION STRATEGY

The Integrated Community Case Management (iCCM) of childhood malaria, diarrhoea and pneumonia, which was developed by the World Health Organisation (WHO) has been rolled out with great success in many countries including Ghana in reducing child morbidity and mortality.

The iCCM strategy extends case management of childhood illness associated with malaria, pneumonia and diarrhoea beyond health facilities to community level.  In other words, the iCCM is a proven evidence-based strategy that trains, equips and supports various groups of community health providers to deliver effective treatment interventions in the community

For the programme to achieve its objectives, the organization implored basic components of the iCCM strategy.  To this end, capacity building of Community Based Agents (CBAs) through training and supply of iCCM commodities/diagnostic tools including; ACTs (Artemisinin-based Combination Therapy), oral antibiotics, oral rehydration salts and zinc, Rapid Diagnostic Tests (RDTs) and counting beads. The CBAs were supervised to diagnose and treat children under five years with malaria, pneumonia and diarrhoea.

Social and Behaviour Change Communication Strategy (SBCC) is a strong component of the programme. The SBCC activities such as community durbars, meetings with caregivers, etc., were carried out by trained CBA’s and project staff to positively influence social determinants of health such as knowledge, attitudes, norms and cultural practices among the people in the communities. The consequence of these activities is to improve health outcomes in households and community levels such as early health seeking behaviours, proper hand washing, Antenatal visit, skilled delivery, exclusive breastfeeding and sleeping under insecticide treated net to limit the impact of ill health.

5.1 Malaria

On malaria, the programme concentrates on both prevention and curative services. The prevention strategies include the distribution and follow up of Long Lasting Insecticidal Treated Nets (LLINs) to encourage correct and consistent usage and care/maintenance of the nets. Usually, this involves supporting the National Malaria Control Program (NMCP)/Ghana Health Service (GHS) in mass LLIN distribution campaigns and conducting post distribution activities. The post distribution activities involve sensitization/education of community members, especially pregnant women and caregivers of children under five years on malaria prevention practices.

In addition, the strategy of community sensitization on the uptake of Intermittent Preventive Treatment during pregnancy (IPTp) by pregnant women is being implored. CBAs use door-to-door visits approach to educate pregnant women on IPTp and the importance of Antenatal Care (ANC) services and encourage them to seek for early and appropriate health services. They identify, register and refer pregnant women who default or have not attended ANC at all.

Besides, the programme also employs a curative strategy of training and equipping Community Based Agents (CBAs) to correctly diagnose and treat uncomplicated malaria in children under five years. The Community Based Agents (CBAs) are given appropriate skills, knowledge and tools such as Rapid Diagnostic Test (RDT) to test for malaria and treat with Artemisinin-based Combination Therapy (ACT). Complicated cases of malaria are referred by the CBAs to the health centres/facilities.

5.2 Diarrhoea

On diarrhoea, the trained Community Based Agents identify signs and symptoms of diarrhoea, and its treatment using ORS and Zinc tablets for children under five years. Mothers and caregivers of children under five years are also taught to identify signs and symptoms, know the appropriate administration of ORS and zinc tablets including other home remedies for the management of simple diarrhoea at home for children under five years.

5.3 Acute Respiratory Infection (ARI)

Again, the trained CBAs diagnose simple Acute Respiratory Infections (ARI) / pneumonia cases and administer antibiotics for children under five years. The strategy includes the use of available simple and effective tools and techniques such as Acute Respiratory Infection Timer and counting beads to diagnose pneumonia in children using respiratory rates for various age groups.

5.4 Social and Behaviour Change Communication (SBCC)

The SBCC strategy is a key component to the iCCM programme. It is aimed at influencing target beneficiaries to take positive decisions regarding malaria, pneumonia and diarrhoea. Trained CBAs develop key messages and communication channels to sensitize community members on the causes, effects and prevention of malaria, ARI and diarrhoea. SBCC activities adopted by the programme include community durbars, meetings with and among caregiver groups, and household visits. These strategies are designed to enhance community awareness on the three disease conditions mentioned above.

6.0 Savings with Education (SwE)

The savings with education program is a savings-led microfinance program that provides basic financial services to the very poor living in rural communities, especially women. It also offers opportunity for ADDRO to give health messages on malaria, diarrhea, pneumonia and basic maternal health issues to the saving groups on their meeting days. In 2016, the Savings with Education Programme was piloted in two sub districts, namely, Sapeliga and Chuchuliga in the Upper East Region. The programme expanded into three more regions, namely; Northern, Upper West and Greater Accra in 2017

7.0 THE TERMS OF REFERENCE

7.1 Purpose of the Evaluation

The purpose of this End-of-Programme Evaluation is to assess the outcome performance, identify early impact, and lessons learnt to inform decisions and practices which will lead to the improvement of the health program including the savings with Education component moving forward. To this end, the evaluation should generate knowledge about what does and does not work in the field and why, and to have that knowledge shape our policy and practice in health programming.

7.2 Objectives of the Evaluation

The objectives of this evaluation include the following:

  1. To assess the performance of the program with regard to its set objectives, indicators/outcomes as indicated in sections 3.0 and 4.0 above.
  2. To assess the effectiveness and efficiency of the project activities in achieving those outcomes
  3. To assess the extent to which the program might have contributed to long-term effect on the beneficiaries.
  4. To identify lessons learned, gaps if any and make recommendations for future consideration for the health work

8.0   KEY EVALUATION QUESTIONS

The End of Phase Evaluation will answer the following broad and specific questions

  • Broad questions
  1. What is the value of the program intervention in relation to national health priorities?
  2. What progress towards the stated outcomes and outputs has been made?
  3. What factors have contributed to achieving or not achieving the intended outcomes
  4. What factors contributed to the effectiveness or ineffectiveness of the program?
  5. To what extent has the program responded to priority health issues?
  6. What are the critical major factors to consider in order to expand or scale up the iCCM strategy?
  7. What is the effect of the savings with education programme on group members’ access to credit and income levels?
  • Specific questions
  1. Are CBAs and community leaders practicing SBCC? Find out the Proportion of CBAs, Volunteers, and Community Leaders who regularly practice SBCC methods with caregivers and the community (probe on proper hand washing with soap, Health seeking, type of SBCC activities and which ones they practice often)
  2. Are caregivers practicing exclusive breastfeeding? Find out the Proportion of infants who received early and exclusive breastfeeding until six months of age
  3. Do women attend ANC? Find out the Proportion of women attending at least 4 ANC visits during the last pregnancy
  4. Do children get appropriate immunization? Proportion of children aged 0-23 months with complete appropriate immunizations
  5. Where do women deliver? Proportion of births attended by skilled health personnel during the last pregnancy
  6. Do women get postnatal visits? Proportion of mothers and children who had postnatal visit within two days of birth
  7. Proportion of children 0-59 months who received Vitamin A supplements
  8. Do households own LLINs? Proportion of households with one LLIN for every two people
  9. Do households repair their torn nets? Proportion of HHs who report repairing LLIN within the last 3 years
  10. Do households replace their worn-out LLINs? Proportion of HHs who report replacing their LLINs within the last 3 years.
  11. Do households use mosquito nets? Proportion of respondents who slept under an LLIN the previous night (the night before the survey)
  12. Do children under 5 sleep under mosquito net? Proportion of children <5 years who slept under LLIN the previous night
  13. Do pregnant women sleep under mosquito net? Proportion of pregnant women who slept under LLIN the previous night
  14. Do pregnant women go for IPTp? Proportion of women who received at least 3 doses of IPTp during last pregnancy
  15. Proportion of HHs who report that women in their HH have reduced time spent in drinking water collection. 4, proportion of HH who know that unwholesome water should be boiled before drinking
  • Do households practice hand washing? Proportion of caregivers reporting knowledge of at least 3 critical times for hand washing
  • Do caregivers know the signs of childhood illness? Proportion of caregivers who know two or more signs of childhood illness that require immediate assessment by CBA or health staff.
  • Do households know the signs and symptoms of simple/uncomplicated malaria? Proportion of respondents who know the signs and symptoms of simple malaria
  • Do households know the signs and symptoms of complicated malaria? Proportion of respondents who know the signs and symptoms of complicated malaria
  • Do households know the signs and symptoms of diarrhoea? Proportion of respondents who know the signs and symptoms of diarrhoea
  • Do households know the signs and symptoms of pneumonia? Proportion of respondents who know the signs and symptoms of pneumonia
  • Do households know how to manage fever, at the household level? Proportion of respondents who know how to manage malaria at the household level
  • Do households know how to manage, ARI at the household level? Proportion of respondents who know how to manage ARI at the household level
  • Do households know how to manage diarrhoea at the household level? Proportion of respondents who know how to manage diarrhoea at the household level.
  • Do CBAs know how to manage malaria at the community or household level? Proportion of CBAs who know how to respond to malaria
  • Do CBAs know how to manage, ARI at the community or household level? Proportion of CBAs who know how to respond to ARI
  • Do CBAs know how to manage diarrhoea at the community or household level? Proportion of CBAs who know how to respond to diarrhoea.
  • Proportion of children under five years with fever in the last two weeks who had a finger prick (RDT)
  • For children diagnosed with malaria, are they given the recommended treatment (ACT)? Proportion of children age 0-59 months with malaria diagnosis who received ACT treatment
  • For children diagnosed with diarrhoea, are they given the recommended treatment (ORS+Zinc)? Proportion of children 0-59 months with diarrhoea receiving ORS+Zinc
  • For children diagnosed with pneumonia, are they given the recommended treatment (amoxicillin)? Proportion of children age 0-59 months with suspected pneumonia receiving amoxicillin.
  • Are children being tested for malaria before treatment? Proportion of children who had blood test confirmation with RDTs before treatment
  • Proportion of children under five years referred by CBAs for further management

9.0 SCOPE OF THE EVALUATION

The Program is implemented in one district in each of the six regions in Ghana except Upper East where two districts are involved. In each of the seven districts, the programme is implemented in one sub-district except in Sefwi Wiawso where two sub-districts are involved The table below shows the programme implementation areas

Table 1: Programme implementation areas

Region District Sub-district
Upper East Bawku West Sapeliga/Goo
Builsa North Chuchuliga
Upper West Nadowli/Kaleo Nanville
Northern Karaga Zandua
Western Sefwi Wiawso Anyinabrim & Abrabra
Ashanti Bosome Freho Nsuaem
Eastern  Akwapim South Parkro

Table 2: Number of communities and CBAs

Region District Sub-district # of communities # of CBAs
Upper East Bawku West Sapeliga/Goo 24 47
Builsa North Chuchuliga 18 36
Upper West Nadowli/Kaleo Nanville 12 25
Northern Karaga Zandua 20 40
Western Sefwi Wiawso Anyinabrim & Abrabra 27 54
Ashanti Bosome Freho Nsuaem 12 24
Eastern  Akwapim South Parkro 27 54

Regarding number of beneficiaries, please note that all households are involved, however, the primary target is Children under five, Pregnant women and Caregivers/mothers.

The ADDRO Integrated Community Health Program is focused on the integrated community case management (iCCM) strategy where malaria, diarrhoea, and pneumonia are the main areas for the intervention. The three-year program is in its final stage of implementation and will end in December 2017.

The following category of persons/groups should be the primary targets for the program’s evaluation. They are; pregnant women, mothers, Caregivers, Children under five years, Community Based Agents (CBAs), Volunteers and Community Opinion Leaders.  However, the ADDRO and Ghana Health Service staff are also within the evaluation scope to provide clarifying information and documentations when the need arises in the course of the evaluation.

10.0 EVALUATION METHODOLOGY FOR BOTH PROGRAMMES

The consultant shall employ both quantitative and qualitative methods in the assessment of the program. The sampling technique/methodology is expected to be scientific and appropriate reasoning should be given for the choice. The consulting team will be expected to develop their set of questionnaire/discussion guide/survey tools and these should be approved by ADDRO and Episcopal Relief & Development before their application.

The consultant is expected to conduct a participatory evaluation providing for meaningful involvement of the partners, volunteers, programme beneficiaries as well as relevant internal and external stakeholders wherever necessary. The methodology for the data collection may include, but not limited to:

  • Interviews (guided by structured and semi-structured questions) and discussions.
  • Review of relevant documents and materials; and
  • Direct observation as appropriate
  • Focus Group Discussion
  • Key informants Interview

11.0 CONTRACT DURATION/PERIOD FOR BOTH PROGRAMMES

The consultant shall have thirty (30) working days (starting from the day the contract will be signed) to complete the entire assignment as detailed in this TOR. In other words, the entire assignment, including submission of proposal, data collection, analyses, and report writing and submission of the final report shall not exceed 30th December, 2017 (Date may change subject to the date contract is signed)

12.0 EXPECTED OUTPUTS (DELIVERABLES) & REPORTING REQUIREMENTS

  1. An inception report that includes detailed methodology, work plan and all necessary survey tools as well as a budget, to be approved by ADDRO
  2. The principal output of the evaluation will be a comprehensive report in MS Word addressing the above mentioned terms of reference (TOR) and the scope of services. It will include recommendations based upon well-argued and substantiated findings and experience.
  3. A first draft report on the evaluation should be provided to ADDRO for feedback. The Consultant may be required to make a presentation of the main findings and conclusions of the draft report to ADDRO.
  4. The final report that describes the evaluation and puts forward the consultant’s findings, recommendations and lessons learned shall be provided within 30 days after the signing of the agreement. The report shall consist of:
  • Executive summary of not more than 6 pages (including a list of the recommendations with their priority level),
  • 35-40 pages detailed report (the main body) and
  • Suggested recommendations, which are expected to focus on, and be limited to, the main issues.
  1. The evaluator shall also submit an electronic copy via email and two (2) hard bound copies of the reports to the Executive Director of ADDRO.
  2. The report shall also include a list of abbreviations and acronyms used in the report and, attached as annexes, a list of persons and institution/organizations consulted during the evaluation.
  3. The structure of the report will closely follow the TOR for the evaluation. It must be clear from the report how the consultants have addressed each TOR.
  4. The report language shall be English and the consultant should ensure that the report is professionally edited.

13.0     USERS AND AUDIENCES OF THE REPORTS

The primary users and audiences of the evaluation report shall be ADDRO and Episcopal Relief & Development.

The secondary users shall be organizations and institutions working on similar programmes or projects in the country, relevant experts, as well as other interested stakeholders.

14.0     CONSULTANTS QUALIFICATION/EXPERTISE REQUIRED

The consulting team/teams should have at least two specialists as members and one of the consultant specialist will be the team leader. The following qualifications and experience are required:

  1. A good University degree in any of the sciences or social science with relevant academic and professional qualifications with at least five (5) years working experience in evaluation research or similar research work /community research work;
  2. Good working knowledge of the environment in the three regions of northern Ghana;
  3. Good understanding of study designs or evaluation designs
  4. Good analytical, writing and drafting skills;
  5. The team leader will be required to have demonstrated leadership skills and experience, negotiation skills, and an understanding of, and commitment to, participatory approaches in order to direct and co-ordinate the activities of the evaluation team.

15.0 HOW TO APPLY

Interested consultants or firms should submit a proposal to include the following; by 22nd November, 2017.

  • Overview of consultant’s capabilities and/or experience
  • Contact details to include physical location, telephone number and email address(es)
  • Description of the services/work to be performed
  • Proposed methodology
  • Proposed team
  • Estimated budget
  • Delivery schedule

All applications should be submitted to the address below;

The Executive Director

Anglican Diocesan Development and Relief Organization (ADDRO)

Post Office Box 545

Bolgatanga

Tel: 03820-22986 / 0203214314 / 0208784567

E-mail: ayeebojacob@gmail.com  and addrojobs@gmail.com