Lead and Associate Consultant at Pro-Health International – Adamawa & Bauchi

Pro-Health International is a faith-based, non- profit organization that has provided free health care services to under-served populations in Nigeria and Africa for over 27 years.

We are recruiting to fill the position of:

Job Title: Lead and Associate Consultant (Conduct Gender and HIV Stigma Analysis)

Locations: Adamawa (2 Positions) and Bauchi (1 Position)
Duration: 35 days (July – August)
Slots: 3

Introduction

Integrated Child Health and Social Service Award (ICHSSA 4) is a – five year, USAID Ц funded project (December 2019 to November 2024). The project is designed to reduce the impact of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) on orphans and vulnerable children (OVC) in Adamawa and Bauchi states respectively.
ICHSSA -4 is implemented by Pro- Health International (PHI) in partnership with Catholic Relief Services (CRS), alongside Civil Society Organisations responsible to case management at the community and household levels. ICHSSA 4 will ensure that OVC are cared for and protected by their households, communities, local and state governments. The project will also ensure that communities promote child and family friendly, gender and HIV sensitive cultural norms and practices.

Study Background

The Nigeria HIV infection rate is beginning to decline just as the states HIV infection rate. States response to HIV and AIDS as recorded over the years, has experienced reasonable increase in scope and quality. The state-level HIV programming has been guided by several policy documents and assessments resulting in an increase in evidence-based response mechanisms. The NAIIS 2018 report indicates that HIV/AIDS prevalence rate in Adamawa State is at 1.2%, and Bauchi at 0.5%. Accordingly, the focus of the HIV interventions in these states is the prevention of new infections and uptake of HIV antiretroviral therapy.
Some factors contributing to the epidemic in the states have been identified to include gender-related issues, stigma and discrimination. These are manifested in many forms; unequal balance of power between men and women, discrimination, denial and violations of rights and dignity; which are the main reasons why people are reluctant to negotiate prevention behaviors, get tested for HIV, disclose their HIV status, and take antiretroviral drugs.
Some studies including the 2020 Global Gender Gap report ranks Nigeria at 128 out of 158 countries in bridging the gender gap. According to the 2018 NDHS report, 84% of working women earn less than their husbands while 15% of women who are working are not paid for work compared to 8% of men. Only 11% of women own any assets (house, land) alone or jointly compared to 37% of men, and 31% of women have experienced physical violence since age 15 while more than one-third of women who have ever been married have experienced spousal violence. International Centre for Research on Women notes that “the epidemic of fear, stigmatization and discrimination has undermined the ability of individuals, families and societies to protect themselves and provide support and reassurance to those affected with HIV/AIDS. These hinder, in no small way, efforts at stemming the epidemic and impacts negatively on individuals, families, workplace and the community at large.
Men and women are affected differently by HIV/AIDS. The gender disparity in the HIV prevalence is greatest among younger adults with females age 20-24 (13%) having about 4 times the prevalence of males of the same age (0.4%). Gender inequalities in HIV/AIDS are most likely attributable to the differential distribution of the risk factors for women and men. Cultural factors encouraging older men who are likely to be HIV infected to have younger female partners contributes to limiting womenТs ability to negotiate safe sex.
Stigma and gender disparity manifests in discriminatory and sometimes violent treatment of people living with HIV, their families and others affected by HIV as well as women and girls. Both stigma and gender disparity can place a limit on education, work, housing and health care. They can amongst others trigger verbal or physical violence, isolation or complete ostracism, domestic abuse, spousal abuse and rape contributing to HIV vulnerability among women and children. They may also affect personal and family life, including the opportunity to marry and to bear and raise children.

Specific Objectives:

The purpose of the gender analysis study is to understand the unique needs and HIV vulnerabilities of men and women, boys and girls with a view to tailoring HIV/AIDS responses as focused interventions and dedicate resources where they are most needed.
However, the HIV/AIDS Stigma index angle of the study will assess HIV-related stigma experienced among PLHIV.
The assessment also aims at exploring stigma and discrimination’s direct and indirect effects on individuals, as well as the opportunities for HIV prevention and treatment.

The evidence in the gender analysis and stigma index study will be used for advocacy and as resource for designing quality HIV programs. The study has six objectives as follows:

To examine gender roles, harmful gender norms and practices as well as stigma that affect sexual behavior, vulnerability to HIV infection, HIV status disclosure, access to HIV care and support services.
To identify relevant and available policies, laws and legal frameworks in the states, LGAs and communities that promotes and/or impede gender equity and anti- discrimination acts.
To examine the relationship between gender role and access to assets in increasing HIV infection, vulnerabilities and access to HIV care and support services.
To conduct a root cause analysis on the nature and drivers of HIV-related stigma in Adamawa State and Bauchi states.
To increase understanding of the burden, consequences of stigma on individuals, and trends regarding HIV-related stigma and discrimination in individual LGAs and across Adamawa and Bauchi States.
To recommended evidence-based and project specific gender and stigma reduction strategies.

Study Framework:

The study will align with the six domains of the Gender Analysis framework developed by USAIDТs Interagency Gender Working Group. This framework will provide concrete ways to collect and organize gender differentials in health area using the following domains:
Access refers to being able to use the resources necessary to be a fully active and productive participant (socially, economically, and politically) in society. It includes access to resources, income, services, employment, information, and benefits.
Knowledge, Beliefs, and Perception refers to the types of knowledge that men and women are privy to (who knows what), the beliefs that shape gender identities and behavior, and perceptions that guide how people interpret aspects of their lives differently depending on their gender identity.
Practices and Participation refers to peoplesТ behaviors and actions in life Ц what they do and how this varies by gender. It encompasses not only current patterns of action, but also the way that people engage in development activities. It includes attending meetings, training courses, accepting or seeking out services, and other development activities. Participation can be both active and passive.
Time and Space – This domain recognizes gender differences in the availability and allocation of time as well as the space in which time is spent. It includes the division of both productive and reproductive labor, identifying how time is spent and committed during the day, week, month, or year, and in different seasons, and determining how people contribute to the maintenance of the family, community, and society.
The objective here is to determine how people in different gender categories spend their time and what implications their time commitments have for their respective availability for program activities.
Legal Rights and Status – Analysis of this domain involves assessing how people are regarded and treated by both the customary and formal legal codes and judicial systems. It encompasses access to legal documentation such as identification cards, voter registration, and property titles as well as rights to inheritance, employment, redress of wrongs, and representation.
Power and Decision-making – This sphere of social life pertains to the ability of people to decide, to influence, to control, and to enforce. It refers to the capacity to make decisions freely and to exercise power over oneТs body and within an individualТs household, community, municipality, and the state. This includes the capacity of adults to decide about the use of household and individual economic resources, income, and their choice of employment as well as to vote, run for office, enter legal contracts, etc.
Relatively, the Stigma Index questionnaire will explore: (1) demographics; (2) experiences with stigma, discrimination, and advocacy; and (3) experiences with testing, disclosure, and access to services. Other areas are experiences with stigma/discrimination from other people; access to health, and education services; internal stigma from homes; rights, laws, and policies relevant to the geographic areas of the study and can add content, as needed, to address local concerns.
Consideration will be given to the unique needs of particular subgroups of women or men (e.g., youths, those living in poverty, people with disabilities, members of minority or ethnic groups, those who live in rural areas, hard to reach and riverine areas) who may face unique barriers or obstacles that prevent them from accessing and utilizing HIV continuum of care and having the same outcomes as other men and women.
Study instruments will be designed as a standardized data collection tool to allow comparison of findings across study sites and within an international context, while at the same time allowing for adaptation to the needs of the local context. As such, while the core questions and content must be retained, researchers can change the wording to the geographic area of the study and can add content, as needed, to address local concerns

Tasks
The following tasks will be carried out by the Consultants:

Initial Briefing – 1 day:

Brief senior management on work plan and conceptual framework

Develop work Plan, Gender and Stigma analytical framework – 2 days:

Using information provided in the SOW develop work plan and conceptual framework to be used to collect and analyze data.

Finalize analysis protocol – 2 days:

Review initial protocol and adapt. The qualitative methods will be used for data collection and analysis.

Conduct desk review – 2 days:

Review of literature will include survey and reports, policies, and guidelines relevant to the study.
Recommended documents for review are: National Demographic and Health Survey, Violence Against Children Survey, National Gender Analysis Report, Strategies for Integrating Gender in HIV/AIDS, HIV Related Stigma, Discrimination and Shame in Nigerian Faith Communities, HIV-related stigma across contexts: common at its core, Measuring AIDS stigmas in people living with HIV/AIDS: the Internalized AIDS-Related Stigma ScaleФ AIDS Care, HIV-Stigma in Nigeria: Review of Research Studies, Policies, and Programmes, and The Nigerian HIV/AIDs Indicator and Impact Survey.
The review will also include a systematic electronic database search for published peer-reviewed journal articles and reports on gender, HIV/AIDS and, gender inequalities, norms, stigma and discrimination as well as other related areas. Key search terms include HIV, AIDS, Gender, Nigeria, Inequality, stigma, discrimination, Adamawa and Bauchi The consultant will share findings of the desk review.

Develop data collection tools – 2 days:

Develop interview guides as well as questionnaires for different categories of respondents for In-depth Interviews, Focus Group Discussion, key informant interviews and questionnaires administration for the different stakeholder groups and respondents.

Conduct data collection exercise – 12 days:

Collection of data via key informant interviews, Inept interviews, focus group discussions and questionnaires.

Document findings and recommendation – 5 days:

Analyze data collected and document findings and recommendations
Recommend issues for inclusion in a Barrier Analysis for gender.

Preliminary report 3 days:

Develop and share preliminary report

Debrief – 1 day:

Present assessment findings and recommendation to Project senior management.

Final report – 5 days:

Submission of final report, factsheet, infographics, tables and slide deck.
Total number of days 35 days

Deliverables:

Protocol that includes sample plan, timeline for fieldwork, data analysis, data management plan, data security etc.
Desk review report
Gender and stigma analytical frameworks
Study instruments/tools (Discussion Guide, questionnaires for the different categories of respondents)
Presentation slides and training tools/materials for field teams
Gender and Stigma hotspots Geo-spatial map
Study questionnaires and encrypted responses (as exports)
Preliminary report including findings and recommendations
Final report and information products (factsheets, infographics and slide deck)

Timeline:

The Gender and Stigma Analysis will require a period of 35 days including weekends and public holidays, executed within a period of 2 consecutive months.

Logistics:

All travel arrangements will be provided by the PHI-ICHSSA 4. A technical support team made up of program specialists and other field staff will assist the consultants (where required) in the fieldwork. However, the research team will consider conducting and collecting data using android mobile phones and other virtual means while observing all precautions necessary for prevention of COVID-19 pandemic.

Qualifications
Required Qualification and Skills for the Consultants (Lead and Associates):

Advanced degree in Sociology, Public Health, Research / Monitoring and Evaluation, International Development, and other relevant fields.
Minimum of 7 years of experience in international development and gender programming.
Experience working on gender and health projects, including HIV projects.
Experience in conducting similar HIV/AIDS surveys e.g. NARHS. NDHS, NAIIS etc
Familiarity with Nigerian socio-cultural norms, values and practices and particularly the northern part of the country
Knowledge of USAID and PEPFAR gender policies and strategies
Demonstrated skills in qualitative and quantitative research methods required.
Demonstrated capacity to analyze complex issues, draw relevant conclusions and produce a comprehensive technical report.
Should speak and read English language fluently with strong writing skills.
Understanding of local Hausa language is highly desirable.
Excellent interpersonal skills, including experience successfully interacting with USAID, implementing partners, government officials, civil society partners, and other stakeholders
Must demonstrate cultural sensitivity, particularly in multi – ethnic and multi – religious contexts.
Must be available for the entire duration of the study.