Introduction
This Terms of Reference (TOR) guides the approach and methodology for the CORE Group Polio Project (CGPP) baseline survey for the USAID supported polio grant implemented in five (5) counties of Jonglei, four (4) of Upper Nile and two (2) in Eastern Equatoria, South Sudan. This document highlights the project background, survey methodology and expected deliverables from the consulting firm hired to conduct the survey.strong text
Project background
Provision of Routine Immunization services is a major challenge for millions of children and women of childbearing age (WCBA) in South Sudan. This is particularly so for the three former states of Jonglei, Upper Nile, and Unity which were most affected by the 2013 South Sudan conflict. The conflict led to the destruction of health facilities, displacement of health staff and destruction of EPI facilities. Flooding during the rainy season in these states further makes it hard to reach children and women with the vital lifesaving vaccines.
According to the National Routine Immunization Taskforce for South Sudan, all the six counties in the country with 0.0% Routine Immunization coverage in 2017 are in the three former states of Jonglei, Upper Nile, and Unity. The Taskforce thus classified the states as top priority requiring additional support to boost the routine immunization coverage.
To address these challenges, World Vision’s Core Group Polio Project through the USAID polio Grant will support a strengthening of immunization system, initiate strong community-based surveillance system in 9 selected counties in the three former conflict-affected states and 2 counties in Eastern Equatoria state of South Sudan. The project will target children less than 1 year and women of child-bearing age with the most needed life-saving vaccines.
The World Vision South Sudan/Core group polio project is designed to supports community-based surveillance, strengthen immunization systems to deliver comprehensive routine EPI services and outreach immunization sessions to hard-to-reach communities within the counties, support social mobilization activities to increase demand creation by beneficiary communities and complement support to polio SIAs and Community Base Surveillance
The Polio project is implemented through national implementing partners in partnership with County Health Departments (CHDs) and full involvement of the beneficiary communities in the following counties; Jonglei state- Akobo, Pochalla, Ayod, Pibor and Duk counties, Upper Nile state- Ulang, Maiwut, Nasir and Longochuk counties and Magwei and Kapoeta East counties of Eastern Equatoria states.
Criteria used for selecting project areas.
Counties with poor routine immunization coverage by December 2016.
Counties currently with the established structure set up by core group Polio Project and its implementing partners.
Counties mostly at the international borders of South Sudan and implementing cross-border activities supported by Core Group
Counties with functional cold chain equipment and yet show low routine immunization coverage over the years
Objectives of the baseline survey
The project plans to undertake a baseline survey to;
- Establish baseline values for USAID Global CGPP Program indicators, particularly those related to routine and polio immunization coverage, knowledge of immunization services, and AFP surveillance.
- The survey will also provide baseline information to guide decision-making process, document lessons learned, and potential points of intervention.
Survey area:
The survey will be conducted in the eleven USAID supported counties of; Akobo, Pochalla, Ayod, Pibor and Duk counties in Jonglei state; Ulang, Maiwut, Nasir and Longochuk counties in Upper Nile state- and Magwi and Kapoeta East counties of Eastern Equatoria state.
Survey scope
The project will solicit a consulting firm to carry out the baseline survey. The consulting firm will identify and use the most appropriate survey techniques. Highlighted below are broad insights into a proposed methodology for use by the consulting firm.
Summary of scope of work
The baseline survey is expected to take place in the eleven counties where the project is implementing in Upper Nile, Jonglei, and Eastern Equatoria states. Tentatively the successful firm/consultants are expected to start the survey approximately on the 16th July 2018 for a period of 25 days for the entire survey from initiation to completion.
The consulting firm is expected to:
Review existing project documents, reports, indicator tracking tables etc.
Collect and synthesize data using a mix of appropriate quantitative and qualitative techniques.
Analyze and triangulate data from different sources to synthesize and generate systematic and logical facts, narratives, conclusions, and recommendations.
Recommend actions relevant to the current context appropriate for maternal and child health program activities and routine immunization in particular in the context of the survey area.
Interact with direct and indirect project participants, their household members, project and partner staff, and government staff.
Ensure inclusiveness and representation of various individuals, groups and partners.
Survey Methodology
Survey design
The consulting firm will undertake a mix quantitative and descriptive survey. Data will be obtained through a carefully designed KAP (Knowledge, Attitudes, and Practice) survey questionnaire. Study participants will be sampled from CGPP project areas to understand the characteristics of the project participants and ascertain coverage of routine immunization program activities.
Survey target audience
The survey target audience will be children aged 12-23 months and their caretakers, living in the project catchment areas. CGPP Project counties supported through the USAID polio Grant will be purposely selected into the sample.
Sample size determination
The consulting firm will use a 30 by 7 cluster sampling technique developed by Expanded Program for Immunization (EPI) of World Health Organization (WHO) in 1978 to estimate vaccination coverage of children. Results of this survey should be accurate at the 95% confidence level
Sampling techniques and procedures
The firm shall use an appropriate multi-stage cluster sampling technique to select households from the payams within the counties.
A total of 30 villages will be selected within each payam and 7 eligible children living in each village will be selected and included in the survey.
The villages will be selected using probability proportionate to size (PPS) method.
A total of 210 households will be targeted. To cater for low response rate, an additional 10% households will be included in the final number of the households targeted.
Only one child selected randomly by the caretaker will be requested to participate in each selected household.
The first of the 7 children (household) in a village will be selected randomly. An appropriate sampling technique shall be used to select the subsequent 6 children/ households.
Data collection procedures and training
CGPP will support the consulting firm to deploy a team of trained central supervisors from Juba to the counties to supervise data collection. A minimum of two central supervisors will be deployed per county to facilitate data collection in each county.
The central supervisors, in collaboration with each county polio supervisor and the various CHDs, will identify and train 5-6 research assistants at the county level for 2 days, pretest survey instruments to assess the competency of the research tools before data collection.
Each research assistant will be provided with a checklist containing data collection materials and ensure all materials listed are carried to the field. The research assistants will be assigned to specific payams to conduct data collection for a period of 4 days.
The central supervisors will supervise the data collection process, conduct daily debriefing meeting with all research assistants at the end of each day of data collection process, cross-check filled questionnaires for completeness. Debriefing meetings will address challenges met and plan for the next day of data collection.
Data collection instruments and methods
The consultancy firm shall collect the required data through admnistration of KAP survey questionnaires and review of child health cards (when available).
Survey Questionnaires
The baseline KAP survey questionnaire for South Sudan is adapted from the KAP survey tool previously used in other CGPP country programs. The questions focus on child immunization, immunization barriers, and the knowledge of caretakers on immunization and disease surveillance. The questionnaire contains closed ended questions.
Review of Child Health Cards
Child health cards provided by the health workers to the caretakers upon vaccination of their child/ children will be reviewed. Data collector will note the Antigens administered and dates of immunization/ immunization. Due to civil unrest and mobility, it is likely that many caregivers will not have immunization card (s). The use of recall to ascertain the child’s immunization status will also be undertaken and both will be used to calculate the vaccination coverage as is the convention.
NB: The survey will be conducted in counties where CGPP operates. Most of these counties have security challenges; hence utmost care should be taken to ensure the security of data collectors.
Data Analysis
The consulting firm shall use the most appropriate inferential statistical analysis technique to evaluate difference in immunization status and coverage in the study areas. Epi-Info or SPSS software (version 16) software have been proposed for data analysis. It will further provide a descriptive analysis of frequencies of key variables, as well as cross tabulations between important variables.
Quality controls
Ensure controls for quality are in place and utilized throughout the evaluation;
Ethical Considerations
The consulting firm shall ensure ethics and data quality principals for research are adhered to, protocols followed for consent and confidentiality. The firm will integrate inclusiveness, protection, child protection and gender sensitivity during all aspects of the evaluation, including the findings and dissemination of the results.
Roles and Responsibilities
This is an external survey led by a consulting firm, jointly managed by World Vision’s US and South Sudan office. The consulting firm will work closely with the in-country project Director, WV US office, project monitoring and evaluation officers and assistants, and a quality assurance coordinator in rolling out the survey and receiving guidance. Additionally, the following teams will provide additional support:
Quality Assurance Team: the quality assurance team will comprise of CGPP M& E advisor based in the US, CGPP Communication Advisor based in the US, WVSS quality assurance manager, CGPP M& E Coordinator, CGPP M& E Officer.
Ensure the consultant has access to project documents such as the indicator tracking (M&E framework).
Coordinate with the consultants and Secretariat team to input survey processes and tools.
Provide technical oversight on proposed methodologies, sampling techniques, systematic replacements of pre-selected project sites, data collection, and related survey processes.
Coordinate the movements of consultants from Juba to the field.
Ensure the survey is completed within the stipulated time frames, is of quality, and results are disseminated.
Review and provide input on the final reports submitted by the consultants.
Assign project staff to support and supervise the survey process i.e. field visits, field meetings, training, data collection etc.
Project Team: This team consists of CGPP Director, Deputy Director, Project Coordinators, Project officers and CGPP M& E Officers. Their roles include the following;
Review and approve the technical and financial proposals submitted by the consulting firm or individual consultants.
Obtain necessary approvals for data collection and survey administration at all levels.
Review and approval of inception reports submitted by the consultants.
Organize for inception meeting between the consultants and the project team.
Facilitate communication and coordination at all levels for the smooth implementation of the baseline survey.
Coordinate necessary logistical support on the side of the project for the baseline survey.
Facilitate and support dissemination workshop in Juba
Facilitate and support exit meeting between the consultants and the project team at the end of the survey.
Consulting firm/Individual consultants: this will comprise of the consulting firm staff or individual consultant contracted to carry out the baseline survey. Their roles will include the following;
Develop and submit both technical and financial proposal to World Vision
Submit an inception report to the Core Group Polio Project team
Participate in an inception meeting with the project and quality assurance teams
Review and submit a final inception report to the project team within a day of finalizing the inception meeting.
Recruit and train field supervisors and enumerators
Facilitate all necessary field logistical arrangements for the baseline survey
Supervise training of enumerators and data collection
Conduct data collation and analysis for the baseline survey.
Present preliminary survey findings and recommendations during dissemination workshop.
Produce draft and final survey reports within 10 days of finalizing data collection.
Participate in an exit meeting upon submission of the final survey report.
Deliverables: The consulting firm will provide the following deliverables:
Inception Report: the consultant or consulting firm will submit a draft inception report with 2 days upon signing of the contract and a final inception report which includes comments and inputs provided during the inception.
Final reports
The report will be submitted in 3 phases: 1st draft, 2nd draft and final (as PDF and Word document e-copies) in English; including three printed copies of the final report printed in color.
The report will be presented in a World Vision partnership format using the template (to be shared with the consultant at inception meeting)
The report will include a summary survey abstract detailing a summary of indicators, key findings and recommendations
The report will include survey appendices, such as data collection tools, raw and cleaned datasets, transcripts or any other photos.
Raw data (all data-sets in excel and SPSS or any other recommended data analysis software)
Deadlines for the deliverables will be discussed and established with the consulting firm during the inception meeting.
Limitations
The agreed duration of the survey might be affected because of the context of the project implementation areas in terms of any possible insecurity, cancellation of flights due to rains and flooding. The population on the ground might not necessarily be the same with the population projected by the national bureau of statistics due to the population movement, birth and death rates and unrealistic population figures. The findings of the survey might not be transferable across counties, states or national level but its only for the purpose of the project baseline within those contexts.
Budget
The consultant will attach to the proposal a detailed budget indicating costs per line item and submit it to WV.
Experience Required
The consulting firm will have the following requirements, deemed essential to carry out the baseline survey successfully:
Experience of at least 5 years in conducting baseline project surveys, evaluations or assessments.
Experience in undertaking maternal and child health-related surveys with preference to USAID funded projects.
Experience with fragile contexts similar to South Sudan
Ability to speak Juba Arabic is an added advantage, but not a requirement
Additional Requirements
The consulting firm/individual consultants must be operating and registered within South Sudan.
World Vision is a Child focused organization. All consultants will sign and abide by the Child Protection policy.
Contacts
Submit proposals to: [[email protected]]