REQUEST FOR BIDDING PROPOSALS BID Reference 2014/HR/012 To plan, design and implement a qualitative assessment of barriers and determents of mosquito nets utilization among children under the age of five and pregnant women in Mozambique This is an invitation to INDIVIDUALS to express interest and present an application as per below detailed terms of reference (TORS) describing the tasks for which technical assistance is sought. 1. Background and Context Malaria remains a priority public health problem in Mozambique, especially among children younger than 5 years and pregnant women. The Mozambique Malaria Strategic Plan 2012 2016 aims at reaching all the population with at least one prevention measure; the integrated vector management policy identifies long lasting impregnated mosquito nets (LLIN) as the measure to be adopted by the majority of the population in the country for malaria control. With support from the Global Fund, UNICEF and other partners, Mozambique has been implementing mass distribution campaigns of mosquito nets countrywide. According to Ministry of Health data, at least 6 million mosquito nets have been distributed through mass campaigns in the last 3 years, with a target of distributing at least 1 mosquito nets per two people in all areas at risk. In 2013 through the first quarter of 2014, UNICEF has supported the mass distribution of 1,4 million mosquito nets thanks to the contribution of CIDA. The LLINs, were procured through Global Fund and World Bank funding mechanisms, and distributed in 18 districts of the country: 11 districts in Gaza province, 2 in Zambézia, 2 in Nampula, 2 in Niassa and 1 district in Cabo Delgado. A key component of the UNICEF partnership with CIDA in promoting LLINs distribution at scale, is the design and implementation of a qualitative study to understand gender related barriers to access to mosquito nets. The Demographic and health surveys (DHS) 2011 shows that 57% of households owned at least one mosquito net of any type in 2011, and the situation has even improved with distribution of 6 million nets after the survey. However, notwithstanding the communication campaigns implemented during mass distribution and during antenatal care visits, the utilization of mosquito nets is still very low among
the most affected target groups: children under the age of five and pregnant women (35% and 34%, respectively as documented by DHS 2011). Distribution of mosquito nets and implementation of Information, Education and communication (IEC) campaigns alone do not guarantee utilization. Cultural and socio-economic factors, as well as intrahousehold behavior and practices may significantly influence sleeping patterns and the utilization of mosquito nets. These factors may defer from one setting to another. Koenker (2013), in a study implemented in Tanzania, demonstrated that even with higher level of ownership the perceived risk of getting malaria, and perceived comfort of using the mosquito nets influences the use of mosquito nets. On the other hand Tsuang (2010), also demonstrated intra-household inequities of utilization of mosquito nets where children older than 5 year and women older than 50 years were not always using the mosquito nets even with enough nets, or were allocated the worse one by the head of the household. Torn mosquito nets are not effective as preventive measure. This evaluation is intended to assess the barriers and determents to LLINs utilization for children and pregnant women in Mozambique, so to identify those issues that need to be addressed to improve the utilization of mosquito nets; particular attention will be given to the aspect of gender and hence of barriers to utilization for women and girls. 2. Methodology The study will be conducted in selected sites of Zambézia and Gaza provinces, where UNICEF recently supported mass distribution campaigns. Under the overall supervision of UNICEF Health section and in collaboration with C4D specialists, the Contractor will conduct a qualitative research using the following methodologies: Direct observation of behaviors at community and household level related to mosquito net utilization; Key informant interviews with opinion leaders at community level, religious leaders, maternal and child health nurses and, district health managers; central level health managers, NGOs (malaria consortium, world vision, PSI) Focus group discussions with caregivers of children under the age of five, pregnant women, activists and heads of households disaggregated by gender; The contractor will consult and keep informed UNICEF and the National Malaria Control program (NMCP) on the progress of the study. The Consultant will respond promptly to study related needs and issues as they arise and communicate effectively with the UNICEF and NMCP as appropriate.
3. Activities and Tasks The contractor will plan and conduct the assessment of barriers and determinants for mosquito nets utilization among children under the age of five and pregnant women, which will include: To lead on the organization of all stages of the study and delivery to UNICEF of the final study s report; To perform a desk based literature review related to the study objectives; To plan and prepare a detailed working plan; To develop the methodology in consultation with UNICEF (CAPP and Health section) and the National Malaria Control Program; To design the research Protocol including study tools for in-depth interviews and focus group discussion and submit to the Ministry of Health ethical committee; To plan for field work, including identification of specific communities to be included in data collection; To be responsible for identification and training of research assistants (translators, additional researcher if needed) and conduct the field work and collect data in selected provinces (Zambézia and Gaza) and sites; To analyze the study results; To prepare a preliminary report in Word and PowerPoint to be shared with UNICEF, NMCP and the provinces for review; the report will include recommendations for NMCP to address the identified bottlenecks in LLINs utilization; recommendation on communication messages and communication strategies; To present the preliminary report to malaria program working group and the communication working group for feedback and validation; To prepare a final research report which will include an executive summary; To draft a paper in collaboration with UNICEF and NMCP for publication in scientific journals.
4. Deliverable, Timeframe Deliverables The deliverables are: Submit literature review on barriers and determinants for mosquito net utilization relevant to our context and consultancy work plan, by July 25 th ;(in Portuguese) Submit to ethical committee the qualitative study research protocol to determine barriers and determinants for mosquito net utilization among children and pregnant women by August 5 th ; (in Portuguese) Submit preliminary study report with findings and recommendations relevant for policy and implementation (to submit in Word and PowerPoint format); by November 7 th (in Portuguese) Submit final study report, by November 21 st (in Portuguese and English) Timeline: The duration of the consultancy is 70 days spread over 5 month period. The consultancy will tentatively start on the 21 st of July 2014, and terminate no later than the 30 th of November, 2014. A tentative schedule and detailed work plan for the activities and deliverables is suggested below: Months/Activities July August September October November # of working days To do a literature review 4 days To design the research Protocol including tools Meet with NMCP to present the study protocol and obtain their feedback 2 days Review the protocol and submit to the Ministry of Health ethical committee 1 day To design a detailed operational plan for data collection in districts of Gaza and Zambézia To collect data in selected provinces (Zambézia and Gaza) and sites To conduct data analysis and triangulation 13 days 22 days
To identify policy and programmatic aspects regarding utilization of mosquito nets for children under the age of five years and pregnant women; Develop recommendations for NMCP on effective communication campaign for mosquito net utilization among children under the age of five years and pregnant women; To prepare preliminary report in Word and PowerPoint to be shared with UNICEF, NMCP and the provinces for review; To present the preliminary report to malaria program working group and the communication working group for feedback and validation; To prepare final version of the report; To write a paper in collaboration with UNICEF and NMCP for dissemination and publication in scientific journals. 2 days 3 days 1 day 7 days 5. Qualifications and Specialized Knowledge Education: Advanced university Degree in Public Health, Social Sciences or Anthropology Experience and skills: Experience in similar evaluations and qualitative research in health field (5 years); Expertise in qualitative analyses methods and tools (highly desirable); Experience in qualitative study report writing including articles for publication in scientific journals; Previous experience and expertise in malaria field(preferable); Good communication skills and capacity to transfer skills in qualitative research; Understanding of Portuguese language (preferable); Good records of working with Ministry of health counterparts;
6. How to apply Applications from interested candidates must contain the following documentation: TECHNICAL PROPOSAL that must include: a. Curriculum Vitae; b. Letter of Motivation c. Copies of recommendation letters. d. P11 Form (that can be download from http://www.unicef.org/mozambique/overview.html) FINANCIAL PROPOSAL The Financial Proposal must be submitted in a different file/envelop and be presented in simple rate card in Meticais (or USD for International bidders) and should include tabulation details of the inherent fees costs of the consultancy such as travel, accommodation, incidentals. Please notice that UNICEF accept no liability for visas and any taxes, duty or other contribution payable by the consultant on payments made under this contract. No statement of earnings will be issued by the United Nations or UNICEF to the consultant. SUBMISSION: The proposal (Technical/Financial) shall be presented to the UNICEF Office to the following e-mail: hrmaputo@unicef.org indicating under the subject: BID Reference 2014/HR/012 To plan, design and implement a qualitative assessment of barriers and determents of mosquito nets utilization among children under the age of five and pregnant women in Mozambique CLOSING DATE TO RECEIVE APPLICATIONS: 12 July 2014 UNICEF is committed to gender equality in its mandate and its staff. Well qualified candidates, particularly females are strongly encouraged to apply. Only shortlisted applicants will be acknowledged. UNICEF IS A SMOKE FREE ENVIRONMENT