Consultant MNCH by HxCK1kr4

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									                            Terms of Reference (TOR) for Individual Consultant/Contractor


                                         UNICEF-Bangladesh Country Office

                                      Project Title and Work Plan Code #
       National Consultants for Independent Evaluation of the “Accelerating the Implementation of the
       Investment Case for Maternal, Newborn and Child Health in Asia and the Pacific” Programme in
                                                  Bangladesh


Background:
“Accelerating the Implementation of the Investment Case for Maternal, Newborn and Child Health in Asia and the
Pacific” is an initiative funded by AusAid, from June 2011 to June 2013. UNICEF and the University of Queensland
(UQ) Consortium are coordinating the planned work, in partnership with national and sub-national governments.
UNICEF and UQ discuss with national counterparts in each country the objectives of the Investment Case that can
realistically expect to be addressed between now and June 2013.

The Investment Case (IC) approach is a dynamic process to identify key issues and influence impacts upon
maternal and child health within a country. It involves results-based analysis to inform planning, budgeting and
policies, spelling out the costs and benefits of scaling-up packages of high impact interventions for addressing
maternal, newborn, and child health (MNCH) and nutrition. The IC aims to address the main health and nutrition
problems of the most deprived children and families; identify bottlenecks and barriers that contribute to this
deprivation (using the Tanahashi model1); and identify specific strategies to overcome the barriers that have
created disparities. Analysis occurs first at the district level, with potential benefits arising both through the
process of improving the quality and capacity for decision-making, and through reorienting the delivery of
services. By synthesizing several district analyses, there are also potential beneficial impacts upon policy and
programme design at national level. These analyses are also expected to guide the allocation of budgets and
priorities of national and international partners, and to eventually be reflected in actual implementation (e.g.
increased expenditure and actions for prioritized populations, interventions and strategies). Implementation of
these strategies is expected to effectively reduce bottlenecks that impact upon disparities in MNCH, increase level
and equity of coverage, and thereby decrease child and maternal mortality and malnutrition. While the logic of
the IC approach involves these broad steps, in practice, they are not necessarily carried out in a linear fashion,
with steps feeding into each other and occurring in parallel.

Discrete components of the IC approach contribute to achieving these goals: bottleneck analysis, estimates of
potential lives saved through scale-up and reorientation of interventions, costing of interventions, modeling of
cost-effectiveness, and budgeting. While bottleneck analysis will occur in all districts where the IC approach is
used, use of the other components will depend on their usefulness in each context.

The purpose of this independent evaluation is to establish to what extent use of the Investment Case approach
improves programme service delivery, policy-making, strategies and budgets for MNCH, and to understand how
this occurs.
The evaluation design will need to capture a range of impacts – from influencing how planning is undertaken,
programmes are delivered, policies are crafted and the processes by which budgets are decided - to documenting
where shifts in policies, planning and budgeting for MNCH can be demonstrated. The methodology will also aim to
infer changes in processes of planning and decision-making, and capacities to do so, resulting from use of the IC
approach.

  1
      Tanahashi T. Health service coverage and its evaluation. Bull World Health Organ 1978; 56:295-303.
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In addition, the evaluation will aim to capture the more subtle and incremental levels of change that would
indicate increased political prioritization of MNCH as a result of use of the IC approach. Thus, the evaluation will
utilize a study design that documents the extent to which use of the IC approach has influenced decision-making
and political prioritization for MNCH, as well as important contextual factors that have helped or hindered this
process in different country settings. It will document case studies from Bangladesh covered by the project, to
illustrate these processes in a comparative manner and highlight lessons learned.

Bangladesh has been chosen as it has been “early adopters” of the Investment Case approach. Undertaking the
evaluation in these contexts provides the ability to investigate the heterogeneity of use of the IC approach, and to
understand whether there have been impacts from changes to programme delivery at district level to
reconsideration          of         budgets            and          policy        at          national         level.

The evaluation will be undertaken by a lead consultant who will coordinate a national consultant. National
consultant will work from their preferred location and will not be expected to travel beyond the activities specified
below.

The research aims will be pursued through qualitative case studies, augmented by quantitative data collection,
where possible, to triangulate the findings. The case studies will involve both retrospective and prospective
evaluation and the evaluation will be undertaken in 2 phases. Phase 1 will involve document review and key
informant interviews about past experiences of IC processes to inform baseline analyses in each country. Phase 2
will involve further key informant interviews 12 months later, to assess the outcomes of further IC work. Further
information and a suggested evaluation strategy are included in Annex One, for review and revision by the lead
consultant and national consultants in consultation with the Evaluation Reference Group (comprised of
representatives from Governments, UNICEF, AusAID, and UQ).


 2. Purpose of Assignment: To assist International consultant in evaluation of Investment Case approach and it
 effect on programme delivery, policy, planning and budgeting processes and prioritization of maternal,
 newborn and child health issues in Bangladesh
3. Duty Station: Dhaka

4. Supervisor (must be a staff member): Chief, Health

5. Description of assignment (provide detail and in quantitative terms and pages if require)
                         Tasks                             End                          Time Frame
                                                           production/deliverable
                                                           Bangladesh case study
   Phase 1                                                 summarizing the analysis        1. Phase 1 November
   1. Review available documentation regarding the of the Investment Case                  2012 to 31 December
   investment cases that have been (from UQ                process in the selected         2012 (approximately 44
   consortium, UNICEF and other sources).                  countries      and      an      days of work)
   2. Identify key documents available at national and     Evaluation         Report
   sub-national level about the health system and other summarizing the case
   documents relevant to evaluation of investment case studies, comparing the IC
   work.                                                   process between the
   3. Familiarize the lead evaluator with key aspects countries, and putting
   of the structure, governance and context of national forward lessons learned
   health systems at the central and decentralized and recommendations.

                                                                                                            2
  levels. This includes formal structures, as well as
  informal structures and relationships that impact on
  decision making and budget allocation in health.
  4. Identify key stakeholders to be interviewed for
  the evaluation at national and sub-national levels.
  5. Facilitate, organize and assist with interviews of
  key stakeholders by the lead evaluator.
  6. Assist the lead evaluator in the analysis of
  documents and interviews.
  7. Assist lead evaluator in completing draft interim                                2.      Between
  reports to be shared with Evaluation Reference                                  Phases – 1 January
  Group for feedback.                                                             2013 to 31 August 2013
                                                                                  (2 days per month,
  Between Phases                                                                  approximately 16 Days
  8. Provide monthly updates to lead evaluator and                                of work)
  Evaluation Reference Group on status of investment
  case work in the country.

  Phase 2
  9. Assist lead evaluator to conduct second phase of                             3.   Phase 2 – 1
  key informant interviews and document analysis.                                 September     to    31
  10. Assist lead evaluator in second phase of data                               October           2013
  collection.                                                                     (approximately 40 days
                                                                                  of work)
  11. Lead organization of national workshops in each
  country to validate findings.
  12. Assist lead evaluator in producing final country
  reports.

6. Qualifications or Specialized knowledge/experience required for the assignment:
KEY SKILLS, TECHNICAL BACKGROUND, EXPERIENCE REQUIRED
 Advanced university degree in Public Health, Social Sciences, or a related technical field.
 Excellent fluency in English and national official language.
 Fluency in languages used in districts, if different, would be desirable.
 At least ten years’ experience in health systems with:
        o Detailed knowledge of the national and sub-national health system and information sources, with
             particular respect to maternal and child health services
        o Knowledge of the districts in the country where investment case work has taken place
        o Knowledge of national and subnational structures of government and administration
        o National credibility and access to decision-makers
        o Understanding of current planning and budgeting processes




  Please apply directly to: msiqque@unicef.org


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