Migration Health Researcher Assistants

Terms of Reference

Functional Title:                               Migration Health Researcher Assistants

Grade:                                                                  Consultant

Post of Duty:                                      IOM Regional Office for East and Horn of Africa

Duration:                                                            

Remuneration:                                 $75 USD / day

                                       

Background Information

The Regional East Africa PHAMESA team has developed a three year project proposal which aims to support SADC/EAC/IGAD in increasing access to healthcare goods, facilities and services at One Stop Border Posts (OSBP). This project addresses a request from a joint IOM and EAC member states meeting in Kigali, Rwanda in 2011, for IOM to lead on the operationalization of migrant and mobile friendly provision of health services. Trademark East Africa has expressed an interest in a component of this proposal, specifically areas which would strengthen health service delivery in spaces of vulnerability at OSBPs. Additionally, in the past couple of years in East Africa, IOM has been undertaking programming activities and engaging in a dialogue with donors, regional economic commissions and national governments on integration of migration health in OSBPs.

Border posts are considered spaces of vulnerability (Martin, 2012) because of the close interaction between traders and the surrounding community, nights spent by truck drivers passing through customs, sexual interactions by construction crews and lack of continuity of healthcare facilities, goods and services across borders (EAC, COMESA & IGAD, 2011). Additionally, while there are national and international organizations working to address the HIV and health needs of certain key populations) in spaces of vulnerability, a coordinated response is lacking.

In order to design appropriate interventions at OSBPs, IOM will need to carry out rapid assessments in order to identify what health services, goods and facilities currently exist at OSBPs and establish the current needs of the populations. This process will identify existing gaps in availability, accessibility and affordability of health services, as well as the gaps in health service delivery, with an emphasis on avoiding duplication of services in their recommendations to Trademark, other donors and key stakeholders for service delivery programming. Moreover, in order for the three year project to be sustainable and to encourage eventual government or SADC/EAC/IGAD takeover of the service delivery components, the Regional East Africa PHAMESA team intends to continue having regional meetings with EAC, SADC and IGAD members in order to gain buy-in of a three year regional project to increase access to health services at OSBPs.

The objective of this project is to increase knowledge of health vulnerabilities and access to health services in spaces of vulnerability around OSBPs and promote evidence-based policies and service delivery and capacity building (SDCB) interventions that support improved health outcomes.

These assessments will be conducted in partnership with Makerere University (Kampala, Uganda). The process will include a formative stage that includes the development and testing of a standardized rapid assessment methodology at OSBPs. The evidence gathered will be used (a) to inform proposal development that will address the identified health needs and (b) to inform and develop future opportunities for research which could be published in peer reviewed journals (c) to strategically position IOM as a value added partner for OSBP programming by integrating health aspects to migration/mobility.

Objectives of the Assignment

Under the overall supervision of the Principle Investigator (PI) of the study, the incumbent will be responsible for assisting the PI implement a comprehensive health assessment in all One Stop Border Posts.  

Research Design: Mixed method, multi-site design. Both qualitative and quantitative methods of data collection will be collected.

The study includes three components:

• An institutional mapping/health facility assessment component focusing on the available health services;
• In-depth interviews component focusing on selected key informants such as health services providers (pharmacy, public and private facilities),Staff of NGOs providing services at the OSBPs, Bar/guest house/lodge owners or managers and selected community leaders;
• A focus group discussion component for men and women, aged 18 years and older, representing different categories of people in the OSBPS.

Study sites: The study will be conducted at 6 sites/border posts as listed below: Uganda/Rwanda (Kagitumba-Mirama Hills); Rwanda /Uganda (Gatuna-Katuna); Tanzania/Mozambique (Mtambaswala-Negomano); Tanzania/Zambia (Tunduma/Nakonde); Burundi/Tanzania (Kober-Kabanga); South Sudan/Uganda (Nimule-Elegu).

Study Population: The study will focus on different population groups at the selected sites, including female sex workers, truck drivers, night club/bar and lodge owners/attendants, itinerant trader, business/salesmen, customs and immigration officers, uniformed personnel (e.g. security personnel etc) and other mobile population groups. We will obtain estimates of migrant populations from border officials at each OSBP and consequently derive a sample to be interviewed. 

Institutional Mapping: An institutional mapping exercise will be undertaken to map out service providers involved in the provision of health services in the adjacent communities on both sides of the border, to ascertain the range of health and HIV related services that are currently available, and location and capacities of the different health service providers so as to estimate health needs and service delivery gaps in these ‘spaces of vulnerability’.

Focus Group discussions: Focus group discussions (FGDs) will be conducted with different population groups at the selected OSBPs including: FSWs, international migrants, internal migrants (traders), cross– border traders, truckers, boda-boda, immigration, and customs. One FGD, comprising of 8-12 participants, will be conducted for each of the above sub-population group from each of the selected sites/ OSBPs. An effort will be made to include participants from both sides of the border. All FGDs will be tape/voice recorded (with consent) and transcribed into English thereafter. Discussions will take about 1.5 hours on average.

In-depth Interviews (IDIs): In-depth interviews will be conducted with selected informants at the six sites. Suggested categories of informants include:

1.      Health services providers (pharmacy, public and private facilities)

2.      Staff of NGOs providing services at the OSBPs

3.      Bar/guest house/lodge owners or managers

4.      At least two Community leaders at each site.

5.      Selected members of cross border communities with unique circumstances e.g. sex workers, truckers, clients of sex workers etc.

In-depth interviews with selected informants will further explore and deepen our understanding of issues relating health vulnerabilities and access to services for vulnerable populations at OSBPs. In-depth interviews will include introductions and opportunity for clarifications, and will proceed after the completion of a consent form. Interviews will be conducted in a common language (or languages) agreed upon between the facilitator and participant. The discussion will also be digitally recorded with the permission and consent of the participants.

Qualifications

        Education and Experience:

1. Undergraduate university degree required;
2. Completed or soon to be completed Master’s in Public Health, Epidemiology, or related science desired;

c.       Working experience in applied research and participatory development models desired.

d.      Experience in design, implementation, analysis, and dissemination of quantitative and qualitative behavioural research, including reproductive and sexual health, and HIV/AIDS.

e.      Experience in liaising with local and international institutions. 

f.        Familiarity with migration health and social drivers of health and HIV in Africa is a distinct asset.

Competencies:

1. Excellent writing, communication, and negotiation skills; ability to prepare clear and concise reports.
2. Strong analytical and creative thinking skills.
3. Effective resource management skills, familiarity with financial and business administration.
4. Knowledge of a qualitative data analysis packages (e.g. Atlas, Nvivio)
5. Knowledge of a statistical analysis programmes (e.g. SPSS or STATA) and the ability to conduct multivariate analysis desired.
6. Personal commitment, flexibility, efficiency and drive for results.
7. Ability to make effective decisions under time pressure.
8. Demonstrated gender awareness and gender sensitivity.
9. Ability to work effectively and harmoniously with colleagues from varied cultures and professional backgrounds;
10. High level of computer literacy.
11. Familiarity with migration health and social drivers of health and HIV in Africa a distinct asset.
12. Familiarity with standard word processing, spreadsheet, database, publishing, internet research, and e-mail communication.
13. Familiarity with health facility assessments a distinct asset.

4)            Languages

                Thorough knowledge of English; Professional proficiency in French or Swahili an advantage.

Please send CVs and any questions to Eleni Gaveras: Egaveras@iom.int