Lead Consultant at the Center for Clinical Care and Clinical Research (CCCRN) – Akwa Ibom and Cross River

The Center for Clinical Care and Clinical Research is an indigenous, non-profit organization that promotes best practices in health care delivery, medical training and research using locally adapted models of health systems strengthening. CCCRN has established a formidable presence in Nigeria. With the headquarters in Federal Capital Territory and field offices in its operational states, CCCRN built a vast network of health and allied professional staff, partners and collaborators.

Applications are invited for:

Job Title: Lead Consultant

Locations: Akwa Ibom and Cross River
Duration: 45 days (August – December, 2020)
Scope of Work: Consultancy to conduct baseline study for integrated child health and social service award (LOT 1)

Introduction
Integrated Child Health and Social Service Award (ICHSSA) is a five years USAID funded project which commenced on December 19, 2019. 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 Akwa Ibom and Cross River states respectively.

ICHSSA is implemented by Center for Clinical Care and Clinical Research Nigeria (CCCRN) in partnership with Catholic Relief Services (CRS), alongside other local resource experts. The ICHSSA will ensure that OVC are cared for and protected by their households, communities, local and state governments to reduce their vulnerability to HIV. The project will also ensure that communities promote child and family friendly, gender and HIV sensitive cultural norms and practices.

It has the following expected results: –

• Households have increased access to basic services and care for OVC
• Communities ensure that OVC secure their rights
• Local and State Government deliver basic services, detect and respond to child rights violations
• Prioritized targeted services for specific OVC subpopulations delivered

Study Background
The impact of HIV on households is multi-dimensional and has extensive consequences, this is especially for children from families that are affected by the epidemic. The prolonged illness or death of a household member or addition of an orphaned child can disrupt household stability and increase vulnerability. The adverse consequences among children include limited access to education and economic opportunities, and vulnerability to poor health outcomes, including early death, abuse, and poor nutrition.

The 2018 Nigeria AIDS Indicator and Impact Survey (NAIIS) found an HIV prevalence of 1.4% in those ages 15-49 and 0.2% among those under age 14 and below. Globally it was estimated that in 2015, an estimated 29 adolescents acquired HIV every hour. Most adolescents who die of AIDS-related illnesses acquired HIV when they were infants, these children have survived into their teenage years, sometimes without knowing their HIV status.  Adolescents (ages 10-19) and youth (ages 15-24) bear a disproportionate share of the HIV burden, especially in sub-Saharan Africa. Estimates suggest that there has been a 45% increase in AIDS-related deaths among adolescents 15–19 between 2005 and 2015. Adolescence is a time for significant physical, cognitive, emotional and social change. It is also a time of increased risks and vulnerabilities especially for girls, including increased risk of forced/coerced sex and other forms of GBV, child marriage, unplanned pregnancies, etc.

OVC sub-population identified at the highest risk of HIV include Children living with HIV, Children of HIV infected adults, Children of key population and adolescents at high-risk of sexual violence. Others are KP Minors, HIV Exposed Infants at risk of vertical or horizontal transmission of HIV from their infected pregnant mother without appropriate prevention interventions. These children are equally at higher risk of acquiring infections such as TB or other chronic illnesses or deficiencies associated with social determinants of HIV from their parents. Adolescents living in high HIV burden communities are prone to sexual violence and the early exposure to hazards of transactional and cross generational sex. Spectrum and NAIIS analysis showed that adolescents are at higher risk of HIV infection, compared with other age groups.

The purpose of the baseline study will be to provide baseline situational information at project locations which will inform program intervention and strategies. Information from the baseline study will be used as standards to track progress and performance towards achieving the projects outputs and outcomes throughout project implementation.

Study Objectives
The main objective of the baseline study is to gain a better understanding of the target beneficiaries, their families, the institutional environment and implications that affect their activities, wellbeing and clinical outcomes.

This intended outcome of the study would ensure that ICHSSA 1 program interventions meet the needs of beneficiaries and lead to improved population well-being and reduced vulnerability to HIV/AIDS. The baseline assessment aim at achieving the following:

• Identify the benchmarks for the project’s intended immediate, intermediate, and ultimate outcomes as it relates to the initial indicators set in the logical framework and project indicator performance tracking tool (IPTT)
• Provide evidence on key contextual factors, and verify understanding of the social norm (power dynamics at HH and community level), HIV situation and social needs of vulnerable children, caregivers and households
• Collect and analyse relevant information in terms of sources and level of income, food security situation, access and control to available productive resources and malnutrition.
• Establish evidence on the community and government approach to OVC response in terms of coordination, services delivery, planning, budgetary investment, social workforce, monitoring systems and data management at the State and local government level
• Develop specific recommendations on strategies that will be integrated into the project intervention and used in updating the project monitoring and evaluation plan.

Study Area and Population:

• The study would be conducted in two states of Akwa Ibom and Cross River in LGAs to be randomly selected prior to data collection exercise. Akwa Ibom and Cross Rivers States are located in the South-South region of Nigeria with projected population of 5,482,177 million and 3,866,269 million respectively according to the 2017 NBS Demographic Population Bulletin.
• This baseline survey will focus on adults and children (10-17 years) who are receiving HIV treatment support, prevention as well as care and support services interventions through the ICHSSA 1 program. In addition, secondary project  stakeholders would be purposively targeted in Akwa Ibom and Cross River and these comprises of community and religious leaders, Community Care Workers; State and Local Government leadership; which includes Social Welfare Officers , OVC Desk Officers, Community Development Officers, HOD Education,  Budget Officers and health and HIV service providers and staff of community-based organisations (CBOs).

Scope of Work
The baseline study and final report will include the following;

• Demographics of the study population
• Information on the characteristics, strengths and needs of vulnerable children, caregivers and households across the beneficiary streams selected to receive services as well as those in a comparison group in terms of health, stable, safe and schooled.
  • Health:
    • Analysis of Household nutritional status, food security, diet diversity and prevalence of malnourishment among Households
    • General wellbeing, immunization coverage and access to basic mental health care
    • HIV testing status
    • ART adherence and viral suppression
    • HIV/AIDS and Sexual Reproductive Health knowledge and attitudes
    • Access to and Utilization of sexual reproductive health, HIV prevention, care and support services
  • Stable:
    • Analysis of household access to credit and savings
    • Assessment of Households access to money to pay for unexpected expenses
    • Assessment of Household financial capabilities
  • Schooled:
    • Analysis of school enrolment in formal and informal educational opportunities, school progression and early child development of OVC enrolled on the ICHSSA project.
  • Safe:
    • Perception and experience of violence (discipline by parent or caregiver, Intimate partner Violence)
    • Analysis of parent child relationship, communication, and parenting
• ICHSSA 1 alignment and contribution to USAID 95 95 95 goals
• Baseline information on key output, outcome and impact indicators as per program logical framework with focus on young people (0 – 17 years) to inform program strategies and future impact assessments:
  • Baseline information on the government (State/LGA) OVC response in terms of stakeholder coordination, OVC service delivery, planning, Budgetary investment, social workforce and data management at the State and local government level
  • Budget tracking and expenditure analysis of OVC investments at the state and local government level
• Social workforce capacity need assessment
• Information on the community OVC response

Work Assignments (Lead Consultant)
Overall responsibility:

• To lead the baseline study, including the design of the methodology and research tools and the drafting of the final report.

Specific Tasks:

• Conduct a desk review of relevant documents.
• Facilitate a meeting with the Technical Advisory Team on the research objectives and proposed methodology and collect inputs on scope and methodology of the research.
• Design baseline protocol based on Technical Advisory Team recommendations (research methodology and tools.)
• Work with the TAT to validate the tools developed
• Ensure the Technical Team is regularly updated on baseline study progress
• Manage all stages of data collection, cleaning, and analysis
• Prepare research work plan and data collection budget
• Lead/Conduct KIIs and FGDS
• Conduct enumerators training
• Conduct data analysis (Compile, process and analyze information collected during field work)
• Prepare preliminary report and presentation of findings
• Present report and findings to Technical Advisory Team
• Draft final report and recommendations with inputs from the Technical Advisory Team

Methodology
The consultants are expected to develop a suitable methodology, making use of multiple methods and techniques to respond to the objectives of the assignment, and to develop tools for each type of method.

Literature Review:

• Existing quantitative and qualitative studies and surveys related to OVC household wellbeing’s, Demographic and Health Surveys, National AIDS Indicator Surveys, OVC caregiver and Households studies Nutritional Survey’s and Adolescent Sexual reproductive health studies
• State/LGA plans of action and budgets related to children/OVC programming
• NOMIS and LAMIS data

Quantitative Surveys:

• Surveys guided by MER indicators for
• Caregiver/Households survey
• Child survey administered to caregiver
• Adolescent survey

Key Informant Interviews with key stakeholders:

• Government sectors relevant to OVC programming: decision-makers, technical personnel in management and supervision positions, professionals in direct contact with children (social workers, health workers, etc.)
• Community; traditional organizations and leaders, faith-based organizations and leaders, other community-based organizations

Focus group discussions:

• With children and adolescents (by age group), adult caregivers and communities

Ethical Considerations

• The baseline study will be carried out in an ethical way that is sensitive to different cultures, local customs, religious beliefs and practices, personal interaction and gender roles, disability, age and ethnicity. In addition, requirements for participant informed consent and confidentiality will be maintained, including for children participating in the survey. The final report should include a section on ethical considerations. The consultants are expected to identify all the potential ethical issues arising from the proposed methodology.

Timeline

• The Baseline study will require a period of 45 working paid days including weekends and public holidays, executed within a period of 8 Weeks.

Work Schedule
Task and Estimated Number of Working Days:

• Initial Debriefing Meeting – (1day)
• Desk review – (4days)
• Design of baseline protocol and tools including: (6 days):
  • Draft survey tools
  • Draft KII and FGD guides
  • Analytical framework that includes baseline study questions, indicators and related data collection methods
• Pilot testing of tools (2 days)
• Validation meeting with TAT (including preparation and report/finalization) (1 day)
• Training of enumerators and field testing (5 Days)
• Field work data collection (10 days)
• Data processing and analysis (6 days)
• Draft final report writing (4 Days)
• Validation meetings (including preparation and reports) – 2 days
• Final report writing (4 days)

Total Number Of Working Days: 45 days

Deliverables:

• Desk review report
• Final baseline protocol including survey tools, FGD and KII
• Power point presentation/Materials for Enumerators training
• Encrypted responses and FGD & KII transcripts
• Draft report including findings, learnings and recommendation
• Final report and information products (factsheets, Case studies , Infographics and slide decks)
• Updated Indicators Performance Tracking Tool (IPTT)

Supervision:

• The consultant will be supervised by the Director of Programs and Director of Strategic Information and work closely with the Technical Advisory Team.
• The Deputy Chief of party will provide overall guidance to the study team.

Logistics:

• All travel arrangements will be provided by the CCCRN-ICHSSA 1. A technical support team made up of program specialists and other field staff will assist the consultants (where required) in the fieldwork.

Qualifications Required  
Education:

• Master’s Degree in Public Health, Statistics or equivalent in Sociology, Monitoring, Evaluation and Research.

Experience/Expertise

• Minimum of 8 years of professional work experience in a relevant field, i.e. social research and/or child protection, preferably both
• Knowledge/experience of HIV/AIDS, OVC programming or the social service sector
• practical experience in qualitative and quantitative research methodology, evaluation design and implementation
• Excellent research skills, including in the design of methodology and research tools, data collection, compilation and analysis, and evaluation report writing
• Knowledge of PEPFAR MER indicators is desirable
• Experience in conducting similar HIV/AIDS surveys e.g. NARHS. NDHS, NAIIS etc
• Knowledge of USAID strategies on HIV/AIDS Programming

Competencies:

• Communication skills: advocacy, negotiation, tact, workshop facilitation, training, writing skills, verbal presentations, ability to present information in a well-structured manner
• Analytical skills, ability to formulate concepts and strategies
• Planning, management and organization skills, action-oriented, drive for results
• Ability to lead and work with a team, relating with people
• Inter-cultural sensitivity, respect for diversity
• Understanding of local languages in Akwa Ibom and Cross River is an added advantage

Application Closing Date
Not Specified.