“Background”
Trachoma is a leading cause of infectious blindness worldwide, and South Sudan is endemic for this disease. In line with the World Health Organization (WHO) guidelines, South Sudan has been implementing Mass Drug Administration (MDA) campaigns aimed at reducing the prevalence of trachoma. The success of these MDAs is contingent on achieving high drug coverage in affected areas, typically above 80%. To assess the success and coverage levels, an independent coverage evaluation survey (CES) is required.
In 2023, the South Sudan National Ministry of Health (MoH), with support from Amref Health Africa, conducted Mass Drug Administration (MDA) in 2 endemic counties (Nasir and Ayod). Azithromycin (tabs & Syrups) including Tetracycline eye ointment (TEO) was distributed to people of all ages. Each person received a tablet or syrups or TEOs according to the WHO guideline. The dosage and quantity of drugs given is recorded on the tally sheet. This data was then used to calculate the population coverage of MDA, however there is often issues with the data including poor census data and inaccuracies in recording the data
This TOR outlines the role of a consultant tasked with conducting a Coverage Survey to independently verify the reported MDA coverage for trachoma in Nasir County, identify any gaps in drug distribution, and provide lessons learnt as to how to conduct an integrated treatment coverage survey.
Objectives:
The primary objectives of the Independent Coverage Evaluation Survey (ICES) are:
i. To verify the coverage of recent MDA campaigns (Oct 2024) by drug, disaggregated by sex and age.
ii. To identify areas where there was lower MDA coverage or areas which were missed by the recent campaign, in order for relevant action to be taken if required.
iii. To identify areas where there is a significant difference in the coverage as recorded by health system records and investigate data quality concerns.
iv. To determine factors for non-uptake in the recent MDA campaign and to assess if there was any difference as to participation by drug distributed, sex, age and geographic location.
v. To provide lessons learnt as to how to conduct an integrated treatment coverage survey.
Scope of Work:
The consultant selected for this survey will be required to successfully conduct the following technical tasks:
Review of Nasir MDA Implementation Data:
Collect and analyse the administrative data from the MDA, including drug distribution records and coverage reports.
Design of Survey Protocol:
Develop a comprehensive survey protocol, including sampling methodology, data collection tools, and timelines. The protocol should align with WHO’s recommended guidelines for CES.
Sampling and Fieldwork:
Use probability sampling methods to select a representative sample of households within Nasir MDA areas.
Ensure stratification to include all population subgroups, including hard-to-reach populations.
Data Collection:
Develop or adapt structured questionnaires to assess MDA coverage.
Train and deploy survey teams to conduct household surveys and gather data on MDA coverage and missed populations.
Data Analysis:
Analyze survey data using appropriate statistical methods (e.g., confidence intervals, coverage proportions).
Compare the survey findings with reported administrative data to identify discrepancies.
Reporting:
Provide a comprehensive report that includes findings on the overall MDA coverage in Nasir County, gaps in coverage, and population groups with low coverage.
Offer actionable recommendations for improving future MDA campaigns.
Methodology:
The CES should use a cross-sectional household survey design with probability sampling to ensure representative results.
The following steps will be included:
Sampling Framework:
Develop a sampling strategy that covers both urban and rural populations, and areas known for high trachoma prevalence. WHO’s CES guidelines recommend cluster sampling to ensure representation across various geographic areas.
Survey Tools:
Standardized questionnaires focusing on MDA drug uptake, reasons for non-participation (if applicable), and other relevant demographic data (age, gender, geographic location).
Data Collection Tools:
Data should be collected using digital tools such as tablets with survey software to ensure real-time data capture and minimize errors.
Deliverables
The consultant will be responsible for the following deliverables:
Inception Report : Detailing the survey protocol, sampling methodology, and data collection tools.
Training of Field Teams : Ensure teams are adequately trained in survey protocols and data collection processes.
Raw Data Files : Provide the cleaned dataset in CSV and STATA formats
Final Report: A comprehensive report that includes an executive summary, findings, analysis, and recommendations.
Presentation of Results: Present the findings to key stakeholders, including the Ministry of Health, Amref Health Africa and partner organizations, through a workshop.
Duration of Assignment:
The entire assignment is expected to take a maximum of 5 weeks, with key milestones as follows:
• Week 1: Preparation, review of MDA data, and protocol development.
• Week 2: Training of field staff and finalization of survey tools.
• Week 3: Data collection (including field visits).
• Week 4: Data analysis and report writing.
• Week 5: Submission of the final report and presentation of findings.
Budget
Applicants are expected to submit a detailed budget with line items for:
• Field team costs (training, transport, and per diem).
• Professional fees for:
o Data collection tools and software.
o Data analysis and report production.
Qualifications:
The successful consultant or firm should possess the following qualifications:
• Demonstrated experience in conducting large-scale public health surveys, especially in neglected tropical diseases (NTDs) in South Sudan
• Expertise in statistical sampling methods and data analysis.
• Strong knowledge of trachoma and MDA interventions.
• Proven ability to work in challenging field environments with diverse populations.
• Fluency in English; local language skills (Juba Arabic) are an asset.
Application Process:
Interested consultants or agencies should submit:
• A cover letter detailing their approach to the CES.
• A draft survey protocol.
• Curriculum Vitae (CV) of the lead consultant and core team members.
• A budget proposal.
All applications and inquiries should be directed to the email address Jobs.SouthSudan@amref.org with a subject line *“*Independent Coverage Evaluation Survey for Trachoma Mass Drug Administration (MDA) in Nasir County” to reach on or before 5.00 PM CAT 25th October 2024.
Nasir Trachoma Consultancy Advert 2024_.docx (2.7 MB)
Good Luck