Expression of Interest (EOI) and proposal to undertake End of Project Evaluation

Project Title: Ensuring improved access for older people and other vulnerable groups to treatment for chronic conditions and other healthcare support
HELPAGE REFERENCE: KEN 139
Project location: Rural arid and semi-arid land of Kasasule Kibwezi district.

Contracting Organization: HelpAge International: Eastern Western Central Africa Regional Development Center (EWCARDC)

Location: Nairobi, Kenya with travel to the field, Kasassule Kibwezi district
Duration: 10 days

Deadline for submission of EoI and interpretation of ToR: 12th December 2012
Email for Applications: helpage@helpage.co.ke, and copy dmwachi@helpage.co.ke

1.0 Introduction:

HelpAge International is inviting qualified external evaluators to submit an expression of interest with interpretation of the Terms of Reference and proposal to undertake an evaluation project entitled, ‘improved access for older people and other vulnerable groups to treatment for chronic conditions and other healthcare support which was implemented between January 2012 and December 2102 in Kibwezi. HelpAge International implemented the programme in partnership with HelpAge Kenya (HAK) and Kasasule Health Center supported by Presbyterian Church of East Africa (PCEA).

HelpAge has a vision to see a world in which all older people fulfill their potential to lead dignified, active, healthy and secure lives and our mission is to work with our partners to ensure that people everywhere understand how much older people contribute to society and that they must enjoy their right to healthcare, social services and economic and physical security. Our experience shows that improving the health of older men and women enables them to live lives of dignity and results to improved well being.

2.0 The purpose and justification of the evaluation
The purpose of the evaluation is to assess the achievements and the impact of the project on the target population, and analyse the project’s contribution to the country’s poverty reduction plans, including those outlined in the Poverty Reduction Strategy Paper, resent achievements/impacts of the programme, lessons learned including recommendations, and best practices that will provide both the community, partners, HelpAge and the donor, Jersey Overseas Aid with valuable information on the implementation of their current strategies and particularly to inform future programming.

The main objectives of the evaluation are:
1. Assess the extent to which the programme contributed to the improved health status and care of older women in Kenya
2. Assess the extent to which the stakeholder involved in the implementation applied the principles of the WHO age friendly health care provision and how these contributed to the effectiveness and efficiency of the mobile clinics operations
3. Collate and analyse the data collected and assist in the interpretation of the same for all stakeholders including older people and the government 4. Assess the appropriateness of the interventions and the assistance provided received by the target group
5. Identify examples/models of effective community actions that can make significant and sustainable improvement to the lives of extremely vulnerable people.
6. Assess the investment worth the funds? Were the activities used the best way to use the money (Value for Money)
7. Asses how the intervention can be scaled up to benefit a wider population

3.0 About the Project:

The main problems that led to the programme were:

• Poor health and lack of access to health facilities due to both long distance to facilities and lack of income to cover the costs of health care (more than 90% of those interviewed reporting this);
• Frequent outbreaks of malaria (51.1% of the population);
• Low level of awareness of HIV and AIDS; high incidence of chronic diseases such as hypertension among those interviewed (36%) and those attending the health facility (35% of older patients diagnosed), diabetics, arthritis, bilharzias, amobiasis, typhoid, worm and jigger infestation with 50% of the people interviewed reporting jigger infestation which they described as common in the area.

Overall Objective of the Project:

To ensuring improved access for older people and other vulnerable groups to treatment for chronic conditions and other healthcare support

Activities

1. Sensitizing health workers to the needs of older people: In collaboration with district hospital, 15 workers from district health facilities will be sensitized to needs of older people and trained in quality management of chronic conditions, which are debilitating and painful if not treated. 20 community health workers will promote appropriate treatment for chronic conditions amongst population of 15,000, including 1,500 older beneficiaries.
2. Improving access to medical services through outreach clinics: 48 outreach clinics, manned by health workers from existing health facilities, will conduct diagnosis of common illnesses and chronic conditions and promote primary care (including talks on healthy living, hygiene, sanitation and nutrition). At least 25% of the total 15,000 people in Kasasule area, including 600 older people, will receive treatment and referral for chronic conditions and other ailments during the outreach services.
3. Promotion of disease prevention: The Kassasule Health Center team, with support from community health workers, will carry out 6 primary health campaigns and provide disinfectants to 500 jigger-infected households. The trained community health workers will be mobilized to spearhead campaigns and distribute insecticide -treated mosquito nets to 1,000 people, in order to prevent spread of malaria. 12 HIV/AIDS awareness campaigns will be carried out. The messages will focus on HIV prevention, transmission; care and support with culturally appropriate and age friendly messages to reach older people who often miss out on general prevention messages.

The Expected Project Results

• Demonstrable improvement in knowledge in at least 13 of the 15 trained health-workers and 15 of the 20 community health workers of how to better meet the needs of older people (verifiable by a follow up tick box questionnaire for the trained health workers)
• Increased diagnosis, treatment and management of chronic health problems including hypertension, diabetes and arthritis (verifiable through hospital records) • Improved knowledge of how to access healthcare, preventative healthcare (including prevention of HIV and AIDS) and healthy ageing among older people in target area (verifiable through survey of sample of older people in project area)
• Reduced incidence of malaria (verifiable through hospital records)

1. The Scope of the Evaluation

The evaluation should specifically address the following five main areas:

• Assessment of the relevance of the project activities to the needs and priorities of the targeted beneficiaries as well as its contribution to the health priorities in the district and nationwide as stipulated in the development plans.
• Assessment of activity implementation and project management (budgetary discipline, effectiveness of contract management, work-planning,)
• Assessment of project impact against the indicators outlined in the project outcomes consider both qualitative and quantitative evidence to support statements of impact made in the analysis; • Identification of key points of learning, best practices and recommendations to inform future programming of partners, HelpAge and partners
• Relevance of the project to HelpAge International global Actions and the Africa wide strategic plan

Key questions that should be considered (in exhaustive)

• How has the health status of older people improved over the programme intervention?
• Focusing on the overall coherence of the programme to PCEA mission and vision, Kenyan Vision 2030 plans, HelpAge global Action, the EWCARDC Regional office strategic annual plans and Complementarity of the objective of the project to those of other public interventions, to what extent has the HelpAge programme achieved the following objectives:

1. Improved the living conditions, health and social status of older women in households within the target communities
2. Improved access to sanitation and respect for older people in the target communities
3. Strengthened local structures, particularly government the health sector staff to other service providers, and community-based organisations to better support women and older women Overall relevance of the project activities and objectives to the needs of the beneficiaries
4. How has the partner capacity to network with other stakeholders e.g. the government, NGOs, and civil society organisations changed

Visibility of the project at district level
• What mechanisms or linkages have been established to assist the target communities to reduce or deal with the impact of discrimination of women with particular focus on older women
• How has the visibility of implementing institutions improved?
• How has the visibility of older men and women improved through the operationalizing the principles of age friendly service provision for older men and women?( kindly note any gender differences)
• What went well, what were the key challenges and how were they addressed?

• To what extent has the partner’s institutional capacity changed with special focus on their effectiveness to implement similar programmes in future? What new skills have the staff attained over the programme period HelpAge management systems and processes contributed to the effectiveness and efficiency of its operations? What partner needs remain to be addressed:

a. Contribution to the promotion of learning, and sharing between the implementing partners and other organisations in the project areas
b. What advocacy activities were undertaken and what were the main challenges and achievements
c. To ensure mainstreaming of ageing issues of older women into relevant strategic policies,

• To what extent have the project activities resulted in any unintended/unplanned results and impacts (both desirable and undesirable) and was this as a result of the project alone?

Recommendations

Make recommendations and draw lessons from this project that:

• Improve the sustainability of the current work focusing particularly on the potential for increased engagement with the health staff, local Government local chiefs, partners and other stakeholders;
• Suggest practical ways and processes that can be used to sustain the achievements of this project and also support new initiatives; how can the intervention be scaled up to benefit a wider population?
• Highlight how advocacy work and engagement with Government officers and other key stakeholders might be exploited in future programming;
• Identify new linkages to make the work more relevant to the context with emphasis on addressing gender inequality and human rights abuse

1. The Overall approach for data collection and analysis

The potential consultants are expected to deliver as follows

a) Send to HelpAge their expression of Interest including interpretation of the TOR and proposed methodology, timeframe and professional fees. Consultants are also expected to explain their competence to deliver the ToR and provide evidence of similar work undertaken in the past including names of references.

b) After the offer of the consultancy and signing the Professional Services Agreement, the selected consultant will then submit an inception report together with tools for the field work and timeframe for the completion of the evaluation exercise.
c) The draft report will cover analysis of the project achievement on the basis of desk review of project proposal, research reports, interim reports to date, HelpAge ( EWCADRC) strategic plan and Global actions, and other relevant self sourced documents and provided by HelpAge
d) Produce a final report should be 15 pages maximum

1. Timeframe
   The consultancy is expected to last not more than 10 working days. The activities are expected to be as follows:

Activity Dates Call for consultancy issued 20 November 2012
EoI and Interpretation of TOR submitted 25th November 2012
Review of EOI 02 December 2012
Selection and professional services agreement finalised 03rd December 2012
Desk review and submission of inception report and data collection tools 04 December 2012

participation of the consultant in a feedback and dissemination workshop in Kibwezi 10-11th December 2012
Field work and Interim report 12- 31st December 2012
Submission of first draft report and presentation to HAI 10th January 2013
Feedback on draft report to consultant 12th January 2013
Final report from consultant ` 15th January 2013

1. Output and Report delivery

8.1 Output
• Meeting to debrief on main findings from field work and consultations
• Final report based on the following format: a contents page; abbreviations glossary; executive summary of no more than 1 pages focusing on key findings and recommendations; the main report of no more than 15 pages
• A clear set of conclusions, recommendations and key lessons emerging from the evaluation work in 2 pages, including guidelines for sustainability and continuity
• Annexes of any supporting documents that might include approach, methodology, people consulted, project sites visited etc.

8.2 Report delivery

• The report should be clear and free from excessive jargon. Technical details should be confined to appendices. Recommendations should also cover how they should be implemented.
• The report should include guidance on the process by which findings will be shared and discussed and how any resulting changes in the report will be included.
• Preliminary debriefing of Final Evaluation findings after the field study, to be presented to HelpAge within 7 days of completion of the fieldwork and associated tasks, a draft report for review and comments by HelpAge, programme staff and implementing partners.

1. Selection, exclusion and award criteria

9.1 Tax Liability:

Settlement of any tax liability arising form this agreement will remain the responsibility of the consultant.

1. 2 Ineligibility Criteria
   All potential contractors that fall into any of the following categories will be excluded from participating in HelpAge procurement procedures:

• If your company/ firm is bankrupt, being wound up, are having your affairs administered by the courts, have entered into an arrangement with creditors, have suspended business activities, are the subject of proceedings concerning those matters, or are in any analogous situation arising from a similar procedure provided for in national legislation or regulations;
• If you have been convicted of an offence concerning your professional conduct by a court judgment;
• If you have been guilty of grave professional misconduct proven by any means that the contracting authority can justify;
• If you have not fulfilled obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the GoK. • If you have been the subject of a court judgment for fraud, corruption, involvement in a criminal organization or any other illegal activity;
• If you have been declared to be in serious breach of contract for failure to comply with previous contractual obligations;

All interested consultants must confirm in writing that they do not fall into any of the above categories.

9.3 Exclusion Criteria
In addition to the ineligibility criteria applied by HelpAge, the following exclusion criteria below apply:

• If the consultant/firm is guilty of misrepresentation in supplying the information required by HAI as a condition of participation in the call for EOI, or fail to supply all of the information requested.

9.4 Award Criteria The following criteria will be considered when selecting the potential consultants:

• Reflection of technical skills, delivery times, etc.
• Compliance with international norms
• Price including any non-direct costs such as transport
• Qualifications and experience of personnel
• References

1. Amendment / Discontinuation of the Agreement:

HAI will enter into a formal professional services agreement with the selected consultant on the basis of assessed expression of interest(s) and subsequent negotiations. The agreement will specify the deliverables expected from the consultant and the timeframe for each of the deliverables which will form the basis for monitoring the agreement.

HelpAge will reserve the right to discontinue the agreement in the event of failure to implement the task or to deliver the agreed outputs or to meet the timeframe. If such discontinuation happens, HAI will have the right not to release the funds to the consultant.

How to apply:

Expression of interest
All interested consultants/firms are requested to write an expression of interest describing their competence in management and a proposal to show how they will deliver on the identified tasks. Deadline for application: 12 December 2012
Please send your application by email to: helpage@helpage.co.ke , copy dmwachi@helpage.co.ke