EUCOOKIELAW_BANNER_TITLE

Aug 012018
 

Organization: UN Children’s Fund
Country: Zambia
Closing date: 13 Aug 2018

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, …

The UNICEF Programme in Cooperation with the Government of the Republic of Zambia (GRZ) is designed to address and mitigate the triple threat of poverty the country’s children face, while responding to the needs with interventions addressing the multiple causative factors.

In response to the combination these threats involve the Programme supports national efforts to improve service delivery in the key areas of: child health and nutrition and HIV and AIDS, quality basic education, water, sanitation and hygiene education, child protection and social policy, advocacy and communication.

To find out more about UNICEF’s work in Zambia, please visithttps://www.unicef.org/zambia/.

How can you make a difference?

Title of the Consultancy

Knowledge Attitude & Practice (KAP) study on adolescent mothers’ knowledge of and use of sexual reproductive health and ante-natal care services in Western and Central Provinces, Zambia.

Purpose of the Consultancy

The purpose of this study is to gain a more in depth understanding of why the uptake of health care services by adolescent mothers is relatively low. This study will inform a Communication for Development strategy to improve adolescent mothers’ access to and uptake of sexual reproductive and ante and post-natal health care services. The study will include

i) literature review; ii) a rapid assessment KAP of knowledge and practices through focus group and key informant interviews in two districts with adolescent mothers and services providers in the Western and Central Provinces.

Background

Zambia continues to record steady improvement in key developmental indicators such as maternal, neonatal and child mortality. Despite this progress, commitments made to improve core indicators of the Millennium Development Goals to improve sexual reproductive health and HIV prevention and treatment have not been attained.

According to the DHS 2013/2014, 98% of women attend ANC, however only 56% attended at least 4 times during the pregnancy and of those attending, early ANC was reported to be 24% only. In 2016, 98% of women who attended ANC were tested for HIV and received their results. For those testing positive, 86% were initiated on ART. This shows that women are coming to seek care in the health facilities but the question is whether the information they get meets their need and provides them with enough information and opportunity to be able to continue accessing services along the continuum. High percentage on HIV testing and ART initiation among pregnant women shows that demand for services is good and there is a need to take this opportunity to offer integrated services that include other SRH services such as family planning, counselling those who are negative to maintain their status etc. The 2016 Zambia Population-based HIV Impact Assessment (Zamphia) Study indicated that amongst 15-19 year old adolescents who gave birth in 2015, 85% knew their status compared to 96% for those age 31-39 years. This is a gap of the 11% that needs to be addressed.

In Zambia, the focus and resources for PMTCT have mainly been dedicated for prevention of vertical transmission of HIV and for treatment, care and support for children, adolescents and adults with HIV while less attention has been given to the other two prongs, namely primary prevention of HIV and prevention of unintended pregnancies among women living with HIV. This inadequacy cuts across all age-groups and more so for adolescent girls and young women. Access to sexual and reproductive health services in general including access to family planning for this age group has been a challenge due to various reasons and yet HIV trends in this group shows there has been very minimal reduction of HIV infection in the past few years. The prevalence of HIV among adolescent girls age 15-19 was 3.3% in 2016 (Zamphia).

With 12% of females and 18% of males aged 15-19 reporting sexual initiation by age 15, the current ages of 16 for accessing some SRH and HIV services without parental consent suggests some significant challenge for younger adolescents especially in an environment where HIV infections in young people is high. Sixty three percent of young people reported that clinic staff talk to them about sex, but not about ways to prevent pregnancy or PMTCT (DHS 2013-2014).

Despite the Government of the Republic of Zambia (GRZ) making significant structural and legal reforms in addressing SGBV, such as the anti-GBV act of 2011 and the Penal code, Zambia continues to record a very high rate of physical violence against women, with 43% of women aged 15-49 years reporting having ever physical experienced violence. Among adolescent girls, 29% reported having ever experienced physical violence, with 13.2 % of them reporting physical violence in the last 12 months (often or sometimes or combined). In terms of sexual violence, 10.4% of women aged 15-49 years and 10.2% of young women aged 20-24 years experienced sexual violence in the last 12 months. The situation is further compounded with 17% of women aged 15-49 years reporting sexual violence since the age of 15 year.

The situation in Zambia is further exacerbated by socio-cultural norms that perpetuate the low status of women in a patriarchal society.

With United Nations, Technical support, the Government of Zambia will implement and scale up

interventions integrating SRHR, HIV and SGBV to improve the health and wellbeing of Zambians mainly adolescent girls and young women, youth and key population to attain Sustainable Development Goal (SDG) 3 and SDG 5 in Central and Western Provinces.

In view of the background, a KAP study has been planned that will further unpack the gaps that needs addressing with the technical support of the United Nations, the Government of Zambia for implementation and scale up of interventions integrating SRHR, HIV and SGBV to improve the health and wellbeing of Zambians adolescent girls and young women, youth and key population in Central and Western provinces. It is envisaged that this initiative will contribute to the country attainment of Sustainable Development Goal (SDG) 3 and SDG 5.

The programme aims interventions including the development and implementation of community-based, differentiated, and targeted interventions of social and behavior change communication strategies for demand creation for sexual and reproductive health, HIV and SGBV services. One of the areas that UNICEF will focus on is to support services for prevention of mother to child transmission of HIV targeting all people but with a special focus on adolescent girls and young people, pregnant and breastfeeding women.

Justification

The 2016 Zambia Population-based HIV Impact Assessment (Zamphia) Study indicated that amongst 15-19 year old adolescents who gave birth in 2015, 85% knew their status compared to 96% for those age 31-39 years. This is a gap of the 11% that needs to be addressed.

Furthermore, with 12% of females and 18% of males aged 15-19 reporting sexual initiation by age 15, the current ages of 16 for accessing some SRH and HIV services without parental consent suggests some significant challenge for younger adolescents especially in an environment where HIV infections in young people is high. Sixty three percent of young people reported that clinic staff talk to them about sex, but not about ways to prevent pregnancy or PMTCT.

Based on the current status of uptake of services, there is a need to unpack why 15-19 year adolescents mothers are not aware of their status compared to older mothers both from the client and the service provider’s perspectives.

The study finding will support in development of messages, job aids and communication interventions with a sharper target audience and the content for the UN joint programme for testing integration of communication approaches for SRH/HIV and PMTCT taking into SGBV contexts. The findings will also influence the planning and decision-making of the provincial and district managers from the two target provinces and encourage dialogue between the service providers and adolescents and the young mothers.

Objectives

The objective of the assignment is to conduct an rapid assessment on knowledge attitude and practices around SRH and HIV focusing on PMTCT among adolescent girls and young women of reproductive age.

Main research question:

What factors (structural, attitudes, policies, socio-economic) promote or discourage access to SRH/PMCT/HIV services by 15-19 year adolescents mothers.

  • What attitudes, behaviours and practices facilitate/hinder adolescents and young women to access SRH and HIV including PMTCT services?
  • Why health workers are are not providing integrated SRHR/HIV/SGBV services?
  • What determine attitudes, behaviours and practices that contribute women of child bearing age especially the adolescents and young mothers to not to bring back their HIV exposed infants or positive for regular HIV services follow up (Mother Infant pair lost to follow up)
  • Description of the assignment (Scope of work) / SPECIFIC TASKS

    Desk Review of Existing Literature:

  • Conduct desk Review on studies carried out in the past 5 years on SRH and HIV focusing on PMTCT
  • Produce a report on findings of the desk review with recommendations on information gaps that will require further data collection along the rapid KAP Assessment
  • Design methodology and tools for collecting data from the target groups on the identified gaps including developing a set of questions adolescents are most interested to have more information on SRH/HIV, SGVB & PMTCT issues
  • Conduct a pilot (in Lusaka) and a rapid KAP to collect data on the information gaps identified for the selected groups in Central and Western provinces
  • Report on Knowledge, Attitude, Practice and Behaviours for SRH, HIV and PMTCT of HIV in the target groups in the two provinces
  • Expected Deliverables

    Tasks

    Expected Output

    Timeframe

    (Tentative)

    Payment Schedule

  • Inception report and work plan
  • Documents

    5 dys

  • Conduct Desk Review
  • Desk Review Report

    7 dys

  • Submit draft desk review report
  • Report on identified gaps

    3 dys

    30%

  • Develop tools for qualitative data collection on gaps identified and testing
  • Data collection Tools

    10 dys

  • Review by research manager and the relevant team
  • Provide inputs into the submitted documents

    10 days

  • Finalization of the tools and
  • desk review and research protocols

    Submission of desk review and final draft tools

    5 days

  • Pilot tools and pretested set of questions adolescents are most interested to have more information on SRH/HIV, SGBV & PMTCT issues and obtain ethical clearance (Lusaka based)
  • Ethical clearance document, final tools and set of questions for the adolescent’s desired information

    15 days

    30%

  • Data collection in 2 districts (one in Central and another in Western province) including verifying the set of questions for the adolescent’s desired information for additional inputs from respondents at the provinces
  • List of research site and respondent covered by category, gender and age

    14 dys

  • Data analysis, data validation and Report writing
  • Draft Report including the final desired questions as an annexure

    10 dys

    20%

  • Stakeholders Consultation
  • Outputs of Stakeholder’s Meeting

    2 dys

  • Draft report writing
  • Draft Report

    5 dys

  • Review by research manager and the relevant team
  • Provide inputs

    10 days

  • Final report writing
  • Final Report

    4

    20%

    Total number of days

    100 days

    REPORTING REQUIREMENTS

    Reporting will be according to the deliverables stated in the table above. Key deliverables include:

  • Inception report and work plan
  • Regular consultations with UNICEF H&N and C4D Unit will be maintained throughout the consultancy period.
  • Desk Review Report
  • Tools, ethical clearance, pilot documentations
  • Minutes of key meetings and their deliberations will be submitted by the consultant a day after the meeting has taken place
  • Draft and final report will be submitted as per the table of deliverables
  • PROJECT MAnagement

    A two-fold technical and stakeholder management approach will be adopted:

  • Technical Oversight: The consultant will be supervised by C4D Specialist to whom the consultant will be directly reporting for technical aspects of the study
  • Partnership Oversight: Consultancy oversight will be provided by the HIV/AIDS Specialist and Chief, Health & Nutrition including maintaining partnership communication loop and periodic updating of the status and findings of the study with the UN and MoH. In addition, H&N will convene the stakeholder meetings with partners for sharing the findings and manage issues of sensitivity, ownership including managing relations with the partners and facilitate obtaining necessary clearance from the authorities for implementing the project where necessary.
  • The consultant is expected to obtain the ethical clearance from authorized ERB
  • The contractual procedure will be guided by the Human Resource Unit as per UNICEF regulations and administered by H&N
  • Regular communication through other means will take place throughout the implementation period and the consultant will be required to provide regular updates on study as necessary
  • LOCATION AND DURATION

  • Starting period: 20 August -31 December, 2018
  • Duration: 100 days
  • Location: The consultant will be based in Lusaka with travel to Western and Central Province for data collection.
  • PAYMent schedule

    The consultant will be paid according to deliverables (see table above) commensurate to consultant’s qualifications and the complexity of the task).

  • (30%) upon delivery of Inception report that stipulates work plan, literature review report;
  • (30%) second payment upon completion of tools development and pilot;
  • (20%) Field work and data analysis;
  • (20%) consultant hands in final report bound and electronic copies.
  • Using UNICEF’s relevant guidelines, the contract will be terminated in the event of non-satisfactory performance. DSA and transport to enable consultant conduct field work in the target districts at the rate stipulated in the UNICEF DSA guideline for payment of a local consultant. The consultant is obliged to manage financial and administrative expectations of data collectors when field work is conducted.

    To qualify as an advocate for every child you will have…

  • Qualifications

  • Advanced University Degree with a Post graduate degree on Social Sciences or related field
  • At least 5 years of experience on research.
  • Experience conducting qualitative research with examples.
  • Able to coordinate research teams.
  • Good writing and communication skills.
  • Good computer knowledge.
  • Fluency in written and spoken English is required.
  • Proven evidence of similar projects undertaken and cleared by ERB*
  • Note:

    *Upon request the recommended consultant may be requested to share reports and documentation of similar studies undertaken * Ethnical Clearance Board (ERB)

    For every Child, you demonstrate…

    UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

    View our competency framework at

    http://www.unicef.org/about/employ/files/UNICEF_Competencies.pdf

    UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

    Remarks:

    Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

    How to apply:

    UNICEF is committed to diversity and inclusion within its workforce, and encourages qualified female and male candidates from all national, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of our organization. To apply, click on the following link http://www.unicef.org/about/employ/?job=514978

    click here for more details and apply to position

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