Consultancy to undertake Data collection for Health Facility Audit and Quality of Care Assessment

Website Oxfam

1. Background

Oxfam is an international non-governmental organisation with presence in 70 countries worldwide and operating through an alliance of 19 affiliates across the globe. Oxfam has been operating in Zambia since 1980s, contributing to poverty reduction, and fighting injustice and inequality. Through one of its affiliates, Oxfam has mobilised resources from the Government of Canada through Global Affairs Canada (GAC) to implement Her Future, Her Choice (HFHC) project in Chibombo and Namwala districts of Zambia. The selection of the two districts was premised on high rates of child, early and forced marriage (CEFM), teenage pregnancy, unsafe abortions, and harmful social norms and cultural practices hindering adolescent and young women access to sexual and reproductive health services.

HFHC is a four (4) year project designed to strengthen sexual and reproductive health and rights (SRHR) targeting adolescent girls and young women in school and out of school. The project was developed to respond to the gender inequality and women’s rights violations undermining access to comprehensive, rights-based sexual and reproductive health information and services for adolescent girls and young women (10 – 24 years). The program directly addresses the barriers that are hindering access to sexual and reproductive health and rights for adolescent girls and young women in communities — particularly harmful social norms, traditional practices and taboos regarding sexuality. In so doing, the project will ultimately contribute to transforming gender inequality and discrimination, which are at the root of these barriers.

This project will contribute to improved SRHR by working around three areas of intervention:

  • Engaging adolescent girls and young women, men and boys, community leaders and norm-setters to understand and transform discriminatory social norms;
  • Strengthening the health system to deliver comprehensive SRH services, including family planning, contraception, safe abortion and comprehensive post-abortive care and secondary prevention services for GBV; and
  • Promoting change in SRHR policy and practice through building the capacity of local women’s rights organizations and youth-led organizations to influence SRHR policy and practice.
  • This consultancy is being sought to contribute to interventions around pillar two of HFHC project as defined above.

2. Timeframes, Deliverables, Tools and Processes

  • The consultancy will be expected to start November 1, 2020 and be completed November 30, 2020 date. Should there be need for an extension as a result of unforeseen circumstances, this will be discussed and agreed with the Consultant.
  • The Consultant will be responsible for conducting data collection for the Health Facility Audit and Quality of Care Assessment for 37 health facilities in Chibombo and Namwala districts under HFHC project. The Consultant, working closely with the Point of Contact in Zambia, is responsible for the planning, implementing, and overall coordination of the survey, including survey logistics and timelines, training data collectors and supervisors, monitoring progress and supervising fieldwork.

Tools/Survey Forms

The tools for the research will be developed by Oxfam in Canada and will be shared with the Consult. These tools constitute three survey forms to be administered during the research as follows;

  • Survey form # 1 – Health Facility Audit
  • Survey form # 2 – Client Exit Interview
  • Survey form # 3 – Client-Provider Direct Observation

Method of Data Collection

Data collection method shall be in-person interviews and direct observation, and all data will be collected digitally using SurveyCTO. Should there be challenges to conduct in-person interviews (e.g. COVID 19 or rainfall), the Consultant and the Point of Contact shall devise an alternative method and communicate this decision to Oxfam Canada promptly.

Handheld Devices for Data Collection

Oxfam will provide handheld devices into which SurveyCTO software will be installed and configured for the purpose of data collection. The survey forms will be pre-programmed by Oxfam and loaded onto SurveyCTO. However, the Consultant will ensure that the programmed survey and translation matches the final survey design and addresses any translation issues.

3. Consultant’s Responsibilities

To undertake this assignment, the Consultant will perform various tasks at various stages of the consultancy. These include;

Preparation and Planning for Data Collection:

In terms of preparation and planning for data collection, the following are the consultant’s responsibilities:

  • In collaboration with Point of Contact in Zambia, prepare study protocol and obtain the necessary ethical clearance/approvals by the Ministry of Health and other competent authorities to carry out the assessment and interviews with client and health providers
  • Pre-test and pilot all tools (questionnaires and SurveyCTO) prior to beginning training and data collection activities.
  • Consultant will work with Point of Contact – Oxfam in Zambia and implementing team to review the data collection tools and guidelines. At this stage, the consultant must ensure that the data collection tools sufficiently capture country context. For example, one of the questions asks regarding health care provider’s profession. If the options provided need to be modified to meet country context then Consultant should identify this change and communicate with Point of Contact – Oxfam in Zambia.
  • Provide all corrections or changes to the Point of Contact – Oxfam in Zambia. The consultant must provide minimum 5 business days to have these changes incorporated onto SurveyCTO survey forms.
  • In collaboration with Oxfam Point of Contact, recruit, hire and train enumerators and/or research team with skills needed to collect data. Ensure compliance with the survey guidance provided by Oxfam.
  • Develop operations plan and fieldwork timelines, adapting as necessary throughout the study timeline. Coordinate with Point of Contact – Oxfam in Zambia on these logistics.
  • Ensure submission and approval from relevant in-country ethics and/or research approval boards for the study.
  • Ensure the enumerators and/or research team have access to appropriate materials to carry out data collection.
  • Ensure data collection smart devices are set up and SurveyCTO software is properly installed and working, and data management system is established.

Training of Data Collectors

In terms of training enumerators, the following are the Consultant’s responsibilities:

  • Develop training materials, including agenda and slides, coordinate, facilitate and lead training for enumerators and/or research team in accordance with the guidance provided by Oxfam team.
  • Point of Contact – Oxfam in Zambia will be the first person to address any questions or clarifications required by Consultant. Point of Contract – Oxfam Canada will be available for additional support.
  • Train enumerators and/or research team on data collection tools, SurveyCTO, smart device usage for data collection and data quality assurance measures.
  • If any changes to the protocol or tools is required, coordinate with the Point of Contact- Oxfam in Country. If the changes are significant then Point of Contact – Oxfam Canada must approve the changes prior to implementation.
  • Ensure enumerators have basic clinical knowledge and experience.

Data Collection Process

In terms of field work for data collection, the following are the Consultant’s responsibilities:

  • In collaboration with the Point of Contact – Oxfam in Zambia, notify the District Health Offices as well as the targeted health facilities about the study and obtain their cooperation and support.
  • Monitor and oversee all field operations in order to ensure adherence to survey protocols and timelines for completion.
  • Review and validate collected data (in the field prior to leaving a survey zone).
  • Conduct data quality assurance checks, including daily monitoring of responses (e.g., verifying data is logical, consistent and complete). Alert supervisors so that enumerators can be supported and advised about their errors and corrective actions.
  • Conduct re-entry of data and/or re-training on data collection procedures, if required.
  • Maintain detailed field notes.

Post-fieldwork Processes

In terms of post-fieldwork, the following are the Consultant’s responsibilities:

  • Coordinate with the Point of Contact – Oxfam in Zambia to indicate completion of data collection.
  • Conduct a review session with the Point of Contact – Oxfam in Zambia and Point of Contact – Oxfam Canada to identify any data entry errors or issues. Document in-detail any re-entry of data or errors if necessary to be edited on SurveyCTO. The Consultant will not be able to edit of the raw data. The editing of raw data will be done by Point of Contact – Oxfam Canada.
  • Submit a summary report regarding the field work and any relevant field notes.

4. Key Guiding Principles for the Audit/Assessment

Respecting Autonomy of Survey Respondents

The Consultant must ensure that the autonomy of the survey respondents is respected. This would include and not limited to:

  • Providing survey participants with sufficient information to make an informed decision as to whether to take part in the survey (informed consent) both before and after the interview.
  • Ensuring that participants are not subject to coercion to take part or penalty for not taking part, including reassurance that there is no risk to their employment by participating, nor that their performance will be shared with anyone.
  • Ensuring that participants are aware that they are free to withdraw at any point without giving a reason and without prejudice.
  • Protecting and respecting personal data provided by participants through rigorous and appropriate procedures to ensure confidentiality.
  • In case of phone-based interviews, ensuring that the participants are in a safe location and/or cannot be overheard by anyone is essential. Ensuring that the participant can answer the survey and not result in any harm to the individual is important.

Quality Control

As indicated above, the Consultant will be required to use ONLY SurveyCTO for data collection. The Consultant must ensure that the survey tools (including translation) match the original survey design. The Consultant is responsible for identifying any skip pattern errors and communicate them to the Point of Contact – Oxfam in Zambia. Survey entries with errors will be re-sampled by the Consultant without additional payment/reimbursement. A detailed quality control matrix shall be discussed and agreed with the Consultant at the inception stage of this assignment.

5. Profile of the Consultant(s) and Research Team

The nature and complexity of the assessment demands special skills, knowledge and above all experience in the field of medical or clinical practice with a particular bias towards Sexual and Reproductive Health. It is therefore recommended that the team to be composed to undertake data collection and assessments should have a good and demonstratable mix of expertise to handle an assignment of this scope. Typically, for this assessment a research team will consist of at least three people to undertake different tasks simultaneously at any given health facility.

The person observing the client-provider interaction should have clinical training (e.g., doctor, nurse, midwife, etc.), and the client exit interviews should be performed by a social scientist with interview experience. Since the facility audit requires the researcher to examine medical equipment and to interview the manager of the facility, the person administering this instrument should have a clinical background and possess interviewing skills.

Highly desirable competencies:

  • Current or previous experience in the local health system or school of public health or university.
  • Familiarity with public health system, local health staff.
  • Knowledge of the geographic area where the survey will be conducted.
  • Experience using SurveyCTO and field data collection. Desirable to have experience in similar health facility audit or quality of care assessment.

6. Application process

Proposals should be no longer than five (5) pages, and include both technical details (methodology and process) and financial information. Note that the budget proposal should only include professional fees related to the level of effort (number of days, daily rates in Zambian kwacha, and number of hours expected to undertake the assignment). All costs related to travel and field work logistics will be handled by the Point of Contact – Oxfam in Zambia.

Include contact information for two NGOs or organizations as references. Please submit an example of prior work along with the proposal; a cover letter outlining relevant years of experience in data collection, Health Facility Audit and Quality of Care Assessments, relevant geographies, SurveyCTO and other relevant research capabilities; biodata of the Lead Consultant and/or any other member of the research team and please specify if someone has clinical/medical background and/or experience with similar assessments. Also provide a statement indicating the Consultant’s average weekly availability for the duration of the contract and flexibility for an extended period should delays arise due to the COVID-19 pandemic.

Please submit your application to [email protected], using job reference number OX/HFHC/02/20. In your application, please ensure that you address your suitability as stipulated by the ToRs. Applications should be received before or on October 20, 2020. Only shortlisted candidates will be contacted for interviews.

Oxfam is committed to safeguarding and promoting the welfare of children, vulnerable young people and adults, and expects all staff and volunteers to share this commitment. We will do everything possible to ensure that only those that are suitable to work within our values are recruited to work for us. This post is subject to a range of screening checks and consenting to Code of Conduct and Child Protection Policy.