TERMS OF REFERENCE – ENDLINE STUDY
Country: Ghana
Project Title: Strengthening Community Systems to Scale-up Community-led Response Interventions to End Neglected Tropical Diseases (NTDs) – Scale-Up Project
Executing Agency: Hope for Future Generations
Start Date: 16th December 2024
Duration: 16th December 2024 to 30th January 2025
1. PURPOSE OF THE ENDLINE STUDY
The general objectives of this Endline study are to:
- Assess the outcomes of the project
- Provide evidence of changes over time
- Identify factors that contribute to success or failure and inform program design and implementation decisions
- Conduct a comparative analysis of baseline and endline data to assess changes in key indicators
2. PROJECT SUMMARY
The Scale-up project has been implemented in 10 NTD endemic districts in the Eastern Region since February 2023 by Hope for Future Generations and Rural Watch. A baseline study was conducted at the beginning of the project with the following objective in mind;
- provide a reference point to enable future measurement, evaluation of the outcomes and the degree and quality of change the project would achieve.
- Assess the situation of NTDs in the districts and communities for planning the project implementation phase
- Ensure accountability for results to the project’s funders, stakeholders, and beneficiaries.
In view of the above, the endline study will refer to the baseline results and compare findings to the baseline data.
The operational districts are classified as high-priority areas for investment by the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) due to their co-endemicity of skin-NTDs. The districts are;
RURAL WATCH
Okere, Lower Manya-Krobo, Asuogyaman, Kwahu West
HFFG
- Denkyembour, Kwaebibirim, Birim North, Akyemansa, Birim South, Achiase
According to the Ghana NTD Master Plan, as of 2019, the Eastern region had the highest number of Yaws endemic districts in the country. The Ghana NTD Master Plan again identifies Eastern region as one of the regions in the country that routinely report Buruli Ulcer cases, with almost 6000 cases reported since 2010. In 2019, the region had the highest number of Buruli Ulcer endemic districts in the country. Also, leprosy is among the skin-NTD diseases prevalent in the region, with all 33 districts in the region classified as leprosy-endemic.
According to the Ghana NTD Master Plan (2021-2025), inadequate public awareness, poor personal hygiene, inadequate disease identification skills, lack of point of care diagnosis, inadequate logistics, poor access to care in very remote areas, stigmatization of patients, and lack of community-level health promotional activities, are the key challenges to Yaws, Buruli Ulcer, Leprosy, and other NTDs’ elimination in Ghana. Also, people with skin-NTDs, together with their families, face inequalities in access to health care. As a result, their conditions are not detected and managed early. Inadequate access to health care services worsens the effects of the diseases on them, not only physically, but also mentally. Additionally, there is poor access to safe water and sanitation in communities affected by NTDs. This exposes people to all the skin-NTDs and is a key driver of skin-NTD co-endemicity in these districts.
Coupled with the above, people affected by skin-NTDs and their families endure stigma and discrimination. This prevents them from seeking care and often results in permanent disability and psychological disorders. Stigma and discrimination also prevent patients from participating in socio-economic ventures like employment, education, and decision-making processes.
Furthermore, people affected by skin-NTDs and their families are least involved in the design, implementation, monitoring and evaluation of interventions that affect them. Their non-participation often leads to lack of community ownership and unsustainable projects. Also, health facilities and health workers in NTD-endemic districts and communities are often poorly resourced and lack the capacity to provide timely detection, diagnosis, and treatment services for patients. Furthermore, lack of employable and/or entrepreneurial skills results in high levels of poverty in communities affected by NTDs. As a result, people are unable to afford basic necessities like health care, housing, clothing, and education.
Global Objectives of the Project
● Eradicating and eliminating skin-NTDs
● Reducing skin-NTDs burden on both affected people and health systems
● Improving planning, management and monitoring of health systems to fight skin-NTDs in an integrated manner
● Improving accessibility, including economic accessibility, of people with skin-NTDs to health services
● Improving access to water and sanitation services in skin-NTDs endemic areas
Specific Objectives of Project
● Empowering the development of Ghanaian CSO and/or networks advocating for action (mobilizing governments to commit their resources, right protection) in favour of impoverished people and communities living with Skin NTDs
● Improving access to water and sanitation services in skin-NTD endemic areas
● Contributing to strengthen and enhance the operational response (favouring community level response) for Skin NTD and its cross-cutting issues with a gender, intercultural and community-based approach taking into account all the social determinants of health
3. RESPONSIBILITIES OF THE CONSULTANTS/SCOPE OF THE ASSIGNMENT
(i) Develop the study protocol for the survey
(ii) Ensure that all ethical procedures are adhered, and participants are protected from harm
(iii) Propose and discuss a methodology that aligns with the baseline approach and design data collection tools for the endline study questionnaires and submit to Management
(iv) Pre-test data collection tools and effect any necessary changes based on findings from the pre-test
(iv) Hire and train the field supervisors and enumerators
(v) Plan the field work logistics in consultation with our Administration and Human Resources Office
(vi) Prepare survey implementation and questionnaire documentation, e.g. supervise data collection
(vii) Undertake data entry, cleaning and analysis
(viii) Write and submit a draft endline study report to HFFG for review
(ix) Address review comments and submit final endline survey report, including datasets, to HFFG
(x) Develop a presentation of the findings of the endline study for dissemination
(xi) HFFG will discuss with the consultant and agree on a timeline to develop a manuscript for publication in a renowned journal
(xii) Ensure accountability for results to HFFG, the project’s funders, stakeholders, and beneficiaries.
4. Expected Deliverables
- Develop endline study protocol (including data collection tools)
- Obtain ethical approval for the endline study
- Obtain permission from the Eastern Regional Health Directorate and implementing districts for the study
- Constitute and train research staff (supervisors and enumerators)
- Plan and execute data collection
- Update Management and Project teams on the tools
- Submit draft report and pretest results
- The final report should include a dedicated section for a comparison analysis of baseline and endline data
- Submit final endline survey report
- Submit a PowerPoint presentation on the findings of the study
- Develop manuscript for publication based on an agreed timeline
The consultant’s contractual obligations are complete once the HFFG Executive Director has reviewed and approved the endline Report for quality and completeness as per the TOR.
5. FEES
Open for negotiation
6. Required Skills and Experience
a. Academic Qualifications:
Post-graduate qualification in relevant fields such as Social Sciences, Development Studies, Monitoring and Evaluation.
b. Experience:
● At least seven years of proven experience in conducting qualitative and quantitative research.
● Previous experience in conducting surveys, baseline/midline and end line and/or prevalence
7. Duration: 45 calendar days
8. How To Apply
Qualified and interested applicants should submit their Cover letter, CV and quotation in a single document in PDF to arecruitment63@gmail.com with the subject heading “Application _NTD endline Study” before midnight of 8th December 2024.
NB: Given the anticipated volume of submissions, only highly qualified candidates will be contacted.