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					                                      Terms of Reference

                                      End-Term Evaluation

     IP RIGHTSS Indigenous People Realising the Improvement of Good Health through
                      Sustainable Structures, Ratanakiri, Cambodia

      Project duration: April 2007 – March 2012; funded by: European Commission (EC)

1. Background

Health Poverty Action (HPA) (formerly Health Unlimited) has been implementing the five year
project in Ratanakiri since early April 2007; the project will end in March 2012. The aim of the
project is to enable Indigenous People (IP) of Ratanakiri to enjoy the highest attainable
standard of physical and mental well-being by improving access of Indigenous People to
appropriate, good quality, health care. Specifically the project will achieve the following results:

   1. Indigenous Peoples Health Association established, recognised and functioning with
      equal representation regarding gender and ethnicity.
   2. The Indigenous Peoples Health Association (IPHA) supports advocacy efforts of IP at
      the local, national and international level.
   3. Health Centre Management Committees (HCMC) are effective in ensuring better health
      services for Indigenous People.
   4. Village Health Support Group (VHSG) representatives effectively promote health and
      health rights and entitlements in their own IP communities.
   5. IPHA staff and VHSG representatives are able to use the media as an effective
      advocacy tool and to document the impact of the project on the lives of IP.

The direct beneficiaries of the initiative are IP communities in the seven districts of Ratanakiri,
and HSPs in the province’s eleven health centres and eighteen functioning health posts.

2. Stakeholders, partners and beneficiaries

         DIRECT BENEFICIARIES                           Male          Female      Total

                                                                                                       1
         VHSG members                                   249         249         498
         HCMC                                           49          49          98
                                                        N/A         N/A         N/A
         IPHA members

         INDIRECT BENEFICIARIES                         Male        Female      Total

         Population of all districts of province 2010   not         not         62 818
         (from OD)                                      available   available

Project partners and stakeholders also include the Ministry of Health (MoH), the Provincial
Health Department (PHD), the OD/SOA, the Department of Ethnic Minority Development
(DoEMD) under the Ministry of Rural Development (MoRD), the Provincial Department of Rural
Development (PDRD), the Deputy Provincial Governor and the District Governors, the NGO
Forum, and MEDiCAM.

3. Purpose of the End-Term Evaluation

The purpose of the End-term Evaluation is to evaluate fulfilment of the Project’s specific
objective, assess Health Poverty Action’s success in delivering outputs and achieving results,
the approaches used, and identify strengths and weaknesses. The evaluation should also look
at the potential for replication beyond the project area and highlight lessons learnt and key
recommendations, including recommendations about the future development of the IPHA.

The evaluation should consider:

3.1.   Project Implementation

3.1.1 Partnerships
    a) Assess the strength of the partnership between Health Poverty Action and each of the
       local partners
    b) Have other partnerships, other than those originally planned, been developed.
    c) How effectively does Health Poverty Action coordinate its activities with other NGOs
       working in the area?

3.1.2 Methodology & Process
    a) What are the strengths and weaknesses of the approaches adopted to implement the
       project with respect to:
                   i. Cultural and political sensitivity
                  ii. Innovative approaches
    b) To what extent have the recommendations and lessons from the mid-term evaluation,
       and any donor visits or reviews, affected project implementation?
    c) What steps have been taken to ensure European Commission and Health Poverty
       Action visibility? To what extent are project stakeholders and beneficiaries aware of


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           who the donor and implementer of this project are?
      d)   How well have Health Poverty Action’s ‘Programme Principles’ been followed?
      e)   What has been the added value of Health Poverty Action’s i) country office ii) regional
           office iii) London-based staff?

3.1.3 Management
    a) Has the staffing and management structure been appropriate to fulfil the project
       purpose and outputs?
    b) Did the project make appropriate and timely adaptations in response to changes in the
       external environment?
    c) Was implementation systematically monitored, and the data used to inform decision-
       making?
    d) Were resources used to their maximum potential?

3.2.       Effects of the Project

3.2.1 Changes
    a) To what extent have project activities and results been achieved and how have they
       contributed to the objectives? Please refer to the most recent logframe (submitted
       01.3.2011)
    b) To what extent have cross-cutting issues (gender, disability, ethnicity, environment
       etc.) been addressed?
    c) To what extent has the project impacted on health policy in the country?
    d) Have there been any unplanned consequences of the project, positive or negative?

3.2.2 Sustainability
    a) Considering financial, institutional and socio-cultural aspects, and with reference to the
       original proposal, in what ways will the project have a sustainable impact in the longer-
       term?

3.2.3 Constraints
    a) Are the assumptions and external constraints originally identified in the project design
       still valid? What new constraints and opportunities have arisen during the project?
    b) To what extent did government policy support or constrain project implementation?
    c) What internal factors helped or hindered the project and what changes did the project
       make to mitigate these constraints?

3.3        Wider Potential

3.3.1 Lessons to be learnt
    a) What lessons learned could be used beyond the project area: (i) within the country);
       (ii) within Health Poverty Action (e.g. management, administration); (iii) in similar
       situations worldwide?



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3.3.2 Influencing policy
    a)  Which particular aspects of the project, if any, could be used to influence health
        policy: (i) within the country (ii) internationally?

3.4     Future
     a) What would be an appropriate direction for Health Poverty Action and IPHA’s future
work in this project area?
     b) What other areas of work could Health Poverty Action or IPHA consider moving into in
the future?
     c) How could (i) partnerships, (ii) approaches and (iii) management be made more
effective?

4. Methodology of the Evaluation

The use of appropriate participatory approaches is essential. Methods to be used could
include:
   1. Focus Group discussions with stakeholders including beneficiaries
   2. Key informant interviews with stakeholders
   3. One to one interviews or discussions with the beneficiaries (eg VHSG members)
   4. Observation of activities in the field
   5. Meetings with staff
   6. Review of Project Proposal and other relevant documents

Please note this is not an exhaustive list.

6.     Background Reading

       Health Poverty Action’s ‘Programme Principles’
       Original Project documents and any changes as agreed with the donor thereafter
         (Proposal, logframe and budget)
       Report of baseline survey
       Survey of IP
       PAR report
       Project Annual Reports to EC (narrative and financial)
       Report of mid-term evaluation
       Annual Budgets
       Any audits conducted (an end-of-project internal audit is planned and may have been
         completed at the time of the evaluation)

7. Profile of the Evaluation Team

The evaluation team will consist of two consultants, a Cambodian national and an
international. One of the two consultants will be identified by Health Poverty Action as the ‘lead
evaluator’ and will be responsible for:



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    taking the initiative on pre-evaluation preparations and coordinating the allocation of
      work.
    facilitating an in-country debrief.
    writing the draft and final reports, with contributions from the second evaluator.

The evaluators will ideally have the following skills/experience:

   1.   Graduates in Public health, Social Sciences or Development Studies.
   2.   Experience in monitoring and evaluation of Community development programmes in
        developing countries using participatory approaches.
   3.   Exposure to Health Communication for development.
   4.   Knowledge of Cambodian health policies.
   5.   Knowledge of IP issues in Cambodia.

Evaluation Team:
Lead Consultant
Second Consultant
The evaluators will be accompanied by an interpreter who will be needed for interviews with IP
beneficiaries. The interpreter will play no other role in the evaluation



8. Timing (Subject to agreement with the lead evaluator)

Early March 2012; contract to be signed during February 2012.

FINAL EVALUATION (15 days)

Preparation: 1 day
The evaluators will review the literature and prepare tools.

Field work: approximately 10 days (including 1 day for debrief)
Interviews of some key informants will be conducted before reaching the project site. This
includes 1 day for writing the draft report.

Report writing: 4 days

Dates and detailed schedule for final project evaluation: subject to agreement with the
evaluator.

Day by day schedule with location, activity and logistic arrangements: to be agreed upon
with the evaluator.

9. Report

Evaluation Report

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The final report should be a maximum 20 pages, excluding annexes, and should be written in
English. It should contain an executive summary of a maximum 2 pages. The report should
follow the following format:

           Title page (max 1 page)
           Short description of reviewers (½ page)
           Acronym list (½page)
           Executive Summary (2 pages)
           Introduction/context (½ page)
           Objectives (½ page)
           Methods (1 ½ pages)
           Constraints (½ page)
           Case Studies1 (2 pages) - please refer to footnote
           Findings (5 pages)
           Conclusions (4 pages)
           Recommendations (2 pages)
           Annexes

The report may include quotes, photos, graphs etc.

The first draft of the report will be sent to the Health Poverty Action Country Director (Andrew
Martin), copied to the Country Programme Coordinator (Ellen Jones), Ratanakiri Programme
Manager (Yajna Elouard), IP Project Manager (Carline Erong) in Cambodia, and the Head of
Programmes (Sameer Sah) and the Programme Officer (Francesco Metti) in London, at the
latest 2 weeks after the end of the field work. The Lead Evaluator will then be sent feedback
on the report within two weeks. The Final report should be sent within one week of the
feedback being sent.

Logistics Arrangements:

Transport: Project cars will transport Consultants to and from the Field

Office contacts:

Country Office Cambodia:
Contact Person: Mr Andrew Martin, Country Director
27, Street 97, Sangkat Phsar Doem Thkov, Phnom Penh, Cambodia.
Landline: +855 (0) 23 215 192/ 214 363
Mobile: +855 (0) 12 997 024

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    Apart from the learning and the replication possibilities brought out by a good evaluation, the consultant will also document at
least two or three case studies from the project. These would be positive cases that would demonstrate the key impact,
innovation or methodology that the project may have pioneered or that may serve as best practice. It would also help us share the
learning from the project with HU worldwide as well as a wider audience through our web site.


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Email: a.martin@healthpovertyaction.org

Project Office:
Contact person: Yajna Elouard, Programme Manager
Village 3, Sangkat Labanseik, Banlung Town
Ratanakiri Province, Cambodia.
Phone +855 (0) 92 26 25 00
Email: pm-rtk@healthpovertyaction.org

Emergency contact:
Mr Andrew Martin, Country Director
27, Street 97, Sangkat Phsar Doem Thkov, Phnom Penh, Cambodia.
Landline: +855 (0) 23 215 192/ 214 363
Mobile: +855 (0) 12 997 024
Email: a.martin@healthpovertyaction.org

ABBREVIATIONS:

  CDHS             Cambodia Demographic and Health Survey
  C-IMCI           Community-based Integrated Management of Childhood Illness
  DFID             UK Department for International Development
  FGD              Focus Group Discussion
  HC               Health Centre
  HCMC             Health Centre Management Committee
  HP               Health Post
  HPA              Health Poverty Action
  HSP              Health Service Provider
  HU               Health Unlimited
  IEC              Information, Education, and Communication
  IP               Indigenous People
  IPHA             Indigenous People Health Action
  MCH              Maternal and Child Health
  MEDiCAM          Membership Organization for NGOs Active in Cambodia's Health Sector
  MoH              Ministry of Health
  NGO              Non-Governmental Organisation
  OD/SOA           Operational Health District/Special Operational Agency
  PAR              Participatory Action Research
  PHD              Provincial Health Department
  RH               Referral Hospital
  VHSG             Village Health Support Group




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