Organization: UN Children’s Fund
Closing date: 13 Aug 2018
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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/.
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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.
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.
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.
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.
Description of the assignment (Scope of work) / SPECIFIC TASKS
Desk Review of Existing Literature:
Desk Review Report
Report on identified gaps
Data collection Tools
Provide inputs into the submitted documents
desk review and research protocols
Submission of desk review and final draft tools
Ethical clearance document, final tools and set of questions for the adolescent’s desired information
List of research site and respondent covered by category, gender and age
Draft Report including the final desired questions as an annexure
Outputs of Stakeholder’s Meeting
Total number of days
Reporting will be according to the deliverables stated in the table above. Key deliverables include:
A two-fold technical and stakeholder management approach will be adopted:
LOCATION AND DURATION
The consultant will be paid according to deliverables (see table above) commensurate to consultant’s qualifications and the complexity of the task).
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…
*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
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.
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