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Consultant – Health and Nutrition Knowledge, Practices and Coverage Household Survey Analysis and Report

Jordan (Jordan)

Consultant – Health and Nutrition Knowledge, Practices and Coverage Household Survey Analysis and Report

Jordan

PURPOSE

The Knowledge, Practice and Coverage (KPC) household survey will measure standardized health and nutrition indicators for Syrian refugees and vulnerable Lebanese, in the Medair-supported SDC project areas. The purpose of the survey is to provide robust data that will inform Medair, MOSA, Ministry of Social Affairs (MOPH) and other NGO programming and provide a strong evidence base to current and potential donors. The analysis will serve to compare key indicators across key target groups, as well as enable a comparison with the 2016 and 2017 KPC surveys.

Country programme Lebanon
Medair contractor Country Director Lebanon
Total time frame 30 working days

–          15 days for analysis/report for 2018 survey

–          15 days for analysis/report on 2016, 2017 and 2018 comparisons

Reports to in Lebanon Technical Health – Lebanon Health Project Manager/ Adviser

Technical M&E – Lebanon Assessments, Monitoring & Evaluation Manager

Reports to at Medair HQ Technical Health – Regional Health Adviser

Technical M&E – M&E Senior Adviser

BACKGROUND:
In 2018 the Syria crisis entered its seventh year with almost 1 million registered, and many more unregistered Syrian refugees continuing to reside in Lebanon, a third of whom live in the Bekaa Valley (UNHCR Data Portal, November 2018). The protracted nature of this conflict has seen the number of refugees residing in Lebanon remain relatively stable since 2014 and the number is not expected to decrease in the immediate future. Syrian refugees make up as much as a quarter of Lebanon’s total population, with 80% of these refugees being women and children. The presence of refugees in such high numbers has strained the political, economic and social stability of the country, stretching basic services and systems that have weakened the host authorities’ capacity to respond to the increased needs, especially in education, water supply and healthcare. Difficult living conditions exacerbated by the weather and poor sanitation and hygiene situation in refugee settlements have a strong impact on the public health situation of the refugees and has increased the risks of outbreaks of communicable diseases.

Since 2014 Medair has been supporting the Ministry of Social Affairs (MOSA) Social Development Centers (SDC) by implementing a project to improve refugees’ and affected host communities’ access to primary health care (PHC) services. Medair in close collaboration with MOSA currently supports seven clinics in Central, West and North Bekaa with a focus on mother and child health in addition to mental health and psychosocial support, through the provision of human resources, medicines, equipment, capacity building and supportive supervision to each of the clinics.

Community Health Volunteers (CHVs) in the SDC catchment area deliver a community health promotion package and have been trained on relevant health topics including exclusive breastfeeding, family planning, essential maternal and newborn care, early marriage, lice and scabies treatment and referral systems. Community midwives provide antenatal care, postnatal care and family planning. CHVs and community midwives carry out household visits, community outreach in Informal Settlements within SDC catchment areas and as well as meet refugees and vulnerable host communities in community shared places.

CONSULTANCY PURPOSE
The purpose of the consultancy is two-fold:
1. Part 1 is to analyze and report on the data collected from the household survey (see ‘Information
on the survey’ section below) and make recommendations on current and future programming for
Medair, MOSA, Ministry of Public Health (MoPH) and other Non-Governmental Organizations
(NGOs). The analysis and reporting will be based on, but not restricted to, key health and nutrition
related indicators, including the following thematic areas:
– Health seeking behavior
– Diarrhea and respiratory tract infection management for children
– Vaccinations
– Reproductive health (including antenatal care, postnatal care and family planning)
– Breastfeeding practices
– Access to reproductive and psychosocial services
2. Part 2 is to carry out a comparative analysis of the 2018 dataset, with those of 2017 and 2016, to
contextually identify and explore statistically significant trends between the three surveys and
propose ways forward, including areas for qualitative research, for Medair, MOSA, MoPH and
other NGOs. This is intended as a first step towards the dissemination and application of findings.

OUTPUTS (INCLUDING TIMEFRAME AND SCHEDULE)
The consultancy will take place between January and March 2019 and will be divided into two parts, as set
out below. The work will take place remotely, except where a locally based consultant is appointed, in
which case a short field trip can be arranged.

Part 1
1.1. Review pre-cleaned data, conduct initial data analysis on the required indicators (using complex
analysis in line with the cluster sampling methodology), and provide a written summary of
provisional results, including point estimates of all required indicators, within 3 working days. [3
days]
1.2 Using appropriate data analysis software, conduct in-depth data analysis based on, but not
restricted to, the required indicators, and provide a draft report (including project background,
methodology, results, discussion, conclusions and recommendations and annexes), within a
further 8 days. [11 days]
1.3 Following Medair feedback (by Regional Health Adviser, Health Project Manager/Adviser, Global
Monitoring and Evaluation Adviser and Assessments, Monitoring and Evaluation Manager),
provide the final report and all raw data analyses (Excel and EpiInfo/SPSS/Stata codes or
dashboards) and databases, within a further 4 working days. [15 days]

Part 2
1.1 Analyse the 2016, 2017 and 2018 data sets together and provide a tabular presentation of point
estimates for all required indicators, including 95% confidence indicators and statistically
significant trends, inclusive of disaggregation of Syrian and vulnerable Lebanese population
groups within 5 working days. [5 days]

1.2 Following Medair feedback (by the Medair representatives as mentioned above) provide a concise
6-8 page commentary around the trends revealed by the data. This is to be presented in the
context of the environment of the Bekaa, drawing on relevant literature as it relates to the
national public health situation. This summary should include some top-line messages that can be
shared with stakeholders including community members. This should be provided within a further
7 working days. [12 days]
1.3 Following Medair feedback on the analysis, provide written recommendations on areas for
further, qualitative, study that would benefit from exploration of underlying causal factors for
notable movements in indicators, inclusive of recommended approach and next steps, within a
further 3 working days. [15 days] (This follow-up qualitative research will be carried out by
Medair either internally, or as part of an additional consultancy, which would be connected
directly with its on-going health programming, and linked to strengthening Medair’s M&E system
and approach more broadly).

SECURITY (FOR FIELD TRIP IN THE CASE OF A LOCALLY BASED CONSULTANT)
All reasonable steps will be taken to provide safety and security for the consultant; both Medair and
consultant accept the inherent risks in working in humanitarian contexts. Medair will not be required to
do more than what is reasonable and possible in the circumstances whilst providing a safe and
appropriate work environment.

CONSULTANCY FEES AND TERMS OF PAYMENT
The consultancy will be carried out remotely, whether by a national or international consultant,
though provision could be made for field visits should a consultant within Lebanon be selected.
The consultancy fees will be negotiated based on a proposed budget that includes daily rates for
the consultant
Fee will be paid by cheque or into a bank account designated by the consultant on the successful
completion of the first report.
The remaining pro-rata fee will be paid when the second report has been finalized and approved
by Medair.
Any visa costs, cost of travel in country of abode, and meals while in transit (up to 3 meals per
day, maximum 20 USD per meal, no alcohol, no snacks/drinks between meals) will be reimbursed
into the designated bank account against receipt.

CONSULTANT RESPONSIBILITIES
Submit to Medair before the starting date of the contract proof of registration as a consultant.
(Only if in Consultant’s country of residence such registration is normal practice.)
Fulfil the above outputs as listed within the timeframe stated.
Comply with Medair Lebanon security plan and recommendations on dress and behavior.

INFORMATION ON THE SURVEY
SURVEY PURPOSE
The Knowledge, Practice and Coverage (KPC) household survey will measure standardized health and
nutrition indicators for Syrian refugees and vulnerable Lebanese, in the Medair-supported SDC project
areas. The purpose of the survey is to provide robust data that will inform Medair, MOSA, Ministry of
Social Affairs (MOPH) and other NGO programming and provide a strong evidence base to current and
potential donors. The analysis will serve to compare key indicators across key target groups, as well as
enable a comparison with the 2016 and 2017 KPC surveys.

SURVEY METHDOLOGY
The survey to be conducted will use a cluster design to enable the calculation of 95% confidence interval
point estimates with acceptable degrees of precision. The sampling frames will be distinct for both Syrian
refugees (made up of those living in informal settlements and those not) and vulnerable Lebanese, such
that two cluster surveys will be conducted.

OBJECTIVES OF SURVEY
The objective of the survey is to collection data on key health and nutrition related indicators at the
household level, including the following thematic areas:
– Health seeking behavior
– Diarrhea and respiratory tract infection management for children
– Vaccinations
– Reproductive health (including antenatal care, postnatal care and family planning)
– Breastfeeding practices
– Access to reproductive and psychosocial services

KEY INDICATORS TO BE MESAURED
The specific to be measured are:

Programme area Indicators
Health care access general  % of mothers of children aged under 5 years of age  in project area who went to qualified  health services when they needed medical services
Reproductive Health (RH) services % Women, Girls, Men and Boys (WGMB) in the targeted communities who correctly identify available RH services  (To be presented disaggregated by sex)
% WGMB in the targeted communities who correctly report where to access RH services
% WGMB in the targeted communities who report that they would be comfortable and able to access these (RH) services as needed  (To be presented disaggregated by sex)
% of mothers of children under 5 years who report accessing RH services in the 6 months prior to the survey
% of mothers of children under 5 years receiving RH services who report satisfaction with support provided
ANC visits  % of mothers of children under two years of age who had 4 comprehensive antenatal visits when they were pregnant with their youngest child
Delivery % of mothers of children under 5 years who delivered at hospital
% of mothers of children under 5 years who delivered by caesarian section.
Postnatal Care (PNC) % of mothers of children under two years of age who received a post-partum visit from an appropriate trained health worker within two weeks after birth of their youngest child
% of children under two years of age who were examined by an appropriately trained health worker 3 days after delivery
Exclusive breastfeeding % of infants 0-6 months who are exclusively breastfed
Family Planning (FP) % of mothers of children under 5 years who report discussing FP with a trained service provider in the 12 months preceding the survey
% of mothers of children 0-23 months who are using a modern contraceptive method
Vaccinations % of children aged 6 months- 5 years who are vaccinated for measles in clinics’ coverage area
% of children aged 6 months- 5 years who are vaccinated for polio in clinics’ coverage area
% of children aged 6 months- 5 years who are vaccinated for Diphtheria and Pertussis and Tetanus (DPT)  in clinics coverage area
% of children age 12-23 months who received age appropriate vaccination at time of survey
Treatment of children with  Acute Respiratory Infection (ARI)  % of children under 5 years with fast or difficult breathing for whom advice or treatment was sought from an appropriate health facility or provider
Treatment of children with diarrhea  % of children under 5 years with diarrhea receiving ORS or zinc supplementation
Prevalence of diarrhea % of children under 5 years that experienced diarrhea in the last 2 weeks
Non Communicable Diseases (NCD) % of mothers of children under 5 years who reported having at least one HH member with NCD
% of women who know 2 or more ways to reduce the risk of NCDs
Psycho Social Support (PSS) services % WGMB in the targeted communities who correctly identify available PSS services  (To be presented disaggregated by sex)
% WGMB in the targeted communities who correctly report where to access PSS services (To be presented disaggregated by sex)
% of mothers of children under 5 years who report discussing PSS with a trained service provider in the 12 months preceding the survey
% WGMB in the targeted communities who report that they would be comfortable and able to access these (PSS) services as needed  (To be presented disaggregated by sex)
% of mothers of children under 5 years who report accessing PSS support services in the 6 months prior to the survey
% of mothers of children under 5 years receiving PSS services who report satisfaction with support provided
Child registration % of children under 5 years officially registered in their country (for Syrians)

SURVEY METHODOLOGY

The surveys to be conducted will use a cluster survey design to achieve 95% confidence interval point estimates with an acceptable degree of precision.

Target population Clusters x cluster respondents Planned household respondents
Syrian refugees (in Informal Settlements) 46 x 32 1472
Vulnerable Lebanese 30 x 24 720
TOTAL 2192

The sampling frames are Syrian refugees (made up of those living in informal settlements only) and vulnerable Lebanese in the catchment areas of the 7 Medair-supported SDCs (Talia, Kawkaba, Brital, Kfarzabad, Marj, Kabelias, Jib Janine). For further details on the clusters selected, see the Annex below. The respondents will be women of child bearing age with children under the age of 5, or their care givers. The data will be collected by approximately 70 enumerators, trained and supervised by Medair staff, using tablets and ODK (Open Data Kit) data collection software. A total of 2192 questionnaires are planned to be completed.

TIMEFRAME / SCHEDULE:

Survey questionnaire pre-testing – November 2018

Enumerator training – December 2018

Field data collection: 10th – 21st December 2018

Consultant: Data analysis and report writing: January – March 2019

Review of draft report – April/May 2019

SECURITY

Medair will liaise closely with the local authorities and Municipalities for security information across Bekaa.

PERSONS TO CONTACT

Survey focal point: Dr Ghada Abou Mrad (Medair Health Project Manager / Adviser): ha-leb@medair.org

M&E focal point: Alastair Punch (Assessments, Monitoring and Evaluation Manager): monitoring-leb@medair.org

FUNDING

Funding for this survey will come from Medair’s donors, Global Affairs Canada-IHA and EU-MADAD.

ANNEX: Sampling approach

General cluster selection procedure:

  1. Syrian refugees:
    1. Using IAMP 56, the number of Syrian refugee households living in Informal Tented Settlement (ITS) within the coverage area of the 7 Medair supported SDCs was broken down by Cadaster and ITS, and a cumulative population list was made.
    2. Based on the total household population, an interval was calculated for 46 clusters, the starting points for which were selected from the cumulative population list using systematic random sampling.
    3. Again using the household data from IAMP 56, the ITS closest to the ‘starting point’ IS were pre-selected so that 32 households with mothers (or care givers) with children under 5 could be identified.
  1. Vulnerable Lebanese:
    1. In the same way that IAMP 56 was used for Syrian refugees in ITS, a cumulative population list of Lebanese was made by household per Cadaster. The general population data (made available by Municipalities for the 2017 survey) was used to create the list, with some adjustments made based on local knowledge.
    2. Again based on the total household population, an interval was calculated for 30 clusters, the starting point Cadasters for which were selected from the cumulative population list using systematic random sampling.
    3. Then, to identify the starting points within the Cadasters, it is intended that the enumerator teams are directed by the Municipality to a starting point in the Cadaster that contains high numbers of vulnerable Lebanese. After the first household has been identified, snowball sampling will be used to reach the 24 required households per cluster.

Syrian refugee cluster selection

PCode PCode Name District Cadaster Cluster selection
52227-01-014 Ghazzé 014 West Bekaa Ghazzé 1
53437-01-114 Serraaine Et-Tahta 114 Baalbek Serraaine Et-Tahta 2
51221-01-026 Taalbaya 026 Zahle Taalbaya 3
51227-01-014 Taanayel 014 Zahle Taanayel 4
51221-01-002 Taalbaya 002 Zahle Taalbaya 5
51231-01-058 Saadnayel 058 Zahle Saadnayel 6
51267-01-094 Barr Elias 094 Zahle Barr Elias 7
51383-01-022 Dalhamiyet Zahlé 022 Zahle Dalhamiyet Zahlé 8
53453-01-003 Brital 003 Baalbek Brital 9
53437-01-065 Serraaine Et-Tahta 065 Baalbek Serraaine Et-Tahta 10
52277-01-045 Marj BG 045 West Bekaa Marj BG 11
52224-01-003 Baaloul BG 003 West Bekaa Baaloul BG 12
52237-01-014 Qaraaoun 014 West Bekaa Qaraaoun 13
52277-01-100 Marj BG 100 West Bekaa Marj BG 14
51231-01-002 Saadnayel 002 Zahle Saadnayel 15
51329-01-014 Haouch El-Ghanam 014 Zahle Haouch El-Ghanam 16
51231-01-101 Saadnayel 101 Zahle Saadnayel 17
51281-01-051 Aanjar (Haouch Moussa) 051 Zahle Aanjar (Haouch Moussa) 18
51281-01-014 Aanjar (Haouch Moussa) 014 Zahle Aanjar (Haouch Moussa) 19
52237-01-005 Qaraaoun 005 West Bekaa Qaraaoun 20
52227-01-009 Ghazzé 009 West Bekaa Ghazzé 21
51264-01-001 Haouch Qayssar 001 Zahle Haouch Qayssar 22
51365-01-093 Terbol Zahlé 093 Zahle Terbol Zahlé 23
51234-01-031 Qabb Elias 031 Zahle Qabb Elias 24
51281-01-036 Aanjar (Haouch Moussa) 036 Zahle Aanjar (Haouch Moussa) 25
51267-01-014 Barr Elias 014 Zahle Barr Elias 26
51383-01-025 Dalhamiyet Zahlé 025 Zahle Dalhamiyet Zahlé 27
52227-01-008 Ghazzé 008 West Bekaa Ghazzé 28
52237-01-016 Qaraaoun 016 West Bekaa Qaraaoun 29
53419-01-007 Haouch Er-Rafqa 007 Baalbek Haouch Er-Rafqa 30
51227-01-001 Taanayel 001 Zahle Taanayel 31
52224-01-007 Baaloul BG 007 West Bekaa Baaloul BG 32
51383-01-082 Dalhamiyet Zahlé 082 Zahle Dalhamiyet Zahlé 33
51237-01-001 Haouch Mandara 001 Zahle Haouch Mandara 34
52227-01-005 Ghazzé 005 West Bekaa Ghazzé 35
53139-01-005 Taibet Baalbek 005 Baalbek Taibet Baalbek 36
51231-01-001 Saadnayel 001 Zahle Saadnayel 37
51234-01-066 Qabb Elias 066 Zahle Qabb Elias 38
52271-01-001 Harimé Es-Soughra 001 West Bekaa Harimé Es-Soughra 39
51267-01-013 Barr Elias 013 Zahle Barr Elias 40
51267-01-011 Barr Elias 011 Zahle Barr Elias 41
51221-01-001 Taalbaya 001 Zahle Taalbaya 42
52227-01-003 Ghazzé 003 West Bekaa Ghazzé 43
52254-01-006 Haouch El-Harime 006 West Bekaa Haouch El-Harime 44
52211-01-003 Joubb Jannine 003 West Bekaa Joubb Jannine 45
52277-01-001 Marj BG 001 West Bekaa Marj BG 46

Vulnerable Lebanese cluster selection

ACode Cadaster District Cluster Selection
52227 Ghazze West Bekaa 1, 2
51224 Jdita Zahle 3
51281 Anjar Zahle 4
51264 Haouch Qayssar Zahle 5
52217 Kamed-Looz West Bekaa 6
51329 Haouch El-Ghanam Zahle 7
52211 Joubb Jannine West Bekaa 8,9
53419 Haouch Er-Rafqa Baalbek 10
52277 Marj West Bekaa 11
51227 Taanayel Zahle 12
53437 Serraaine Et-Tahta Baalbek 13
53119 Douris Baalbek 14, 15
51221 Taalbaya Zahle 16
51231 Saadnayel Zahle 17, 18
53453 Brital Baalbek 19, 20, 21
51267 Barlias Zahle 22, 23,24, 25
51234 Qabb Elias Zahle 26, 27, 28, 29, 30

Deadline for written proposal:

Proposals should be sent to corinna.drechsel@medair.org by 1st January 2019.

We do our best to provide you the most accurate info, but closing dates may be wrong on our site. Please check on the recruiting organization's page for the exact info. Candidates are responsible for complying with deadlines and are encouraged to submit applications well ahead.
Before applying, please make sure that you have read the requirements for the position and that you qualify.
Applications from non-qualifying applicants will most likely be discarded by the recruiting manager.
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  • Organization: Medair
  • Location: Jordan (Jordan)
  • Grade: International Consultant - Internationally recruited Contractors Agreement - Consultancy
  • Occupational Groups:
    • Communication and Public Information
    • Public Health and Health Service
    • Nutrition
    • Documentation and Information Management
    • Statistics
    • Population matters (trends and census)
  • Closing Date:

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