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Final Evaluation of the epidemiology of Hepatitis E

  • Organization: IRC - International Rescue Committee
  • Location:
  • Grade: Level not specified
  • Occupational Groups:
    • Public Health and Health Service
    • Biology and Chemistry
    • Monitoring and Evaluation
    • Malaria, Tuberculosis and other infectious diseases
  • Closing Date:

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Background:

The IRC responds to the world’s worst humanitarian crises and helps people whose lives and livelihoods are shattered by conflict and disaster to survive, recover, and gain control of their future. IRC was founded in 1933 through the advice of Albert Einstein to respond to the needs of people vulnerable to conflict around the world. Since then, it has expanded and evolved to become one of the world’s leading humanitarian organisations. In 2016, more than 26 million people benefited from IRC programs and those of its partner organizations.

There is persistent transmission of Hepatitis E Virus (HEV) in Bentiu Internally Displaced Population (IDP) camp in Rubkona County, Unity State, South Sudan. Cumulatively 2237 cases have been reported since beginning of 2019 when the outbreak was declared with 18 deaths reported cumulatively (Case Fatality Rate; 0.8%). There has been an upsurge of cases in the camp in the first half of 2021 due to reduced WASH in the camp due to funding constraints. HEV transmission has increased from a peak of 53 cases every fortnight by week 28 2021 to 67 cases every fortnight by week 10 2022.

As per January 2022 head count, Bentiu IDP camp hosts over 107,390 people and is divided into five sectors (sector 1=13,642, sector 2=18,853, sector 3=28,163, sector 4=19,508 and sector 5=27,224) HEV cases are reported from all sectors, highlighting widespread transmission. However, sector specific attack rates for HEV disease for 2022 are the highest in sectors 3 and 5. This is concerning particularly due to continued expected population movement into the IDP camp due to insecurity, subnational conflict, and seasonal flooding.

Purpose of Endline Evaluation:

This outbreak and HEV continued transmission has exposed the need for more efforts to scale up preparedness and response activities, drawing from available evidence and learning generated from ongoing responses. This endline evaluation will assess the hepatitis E Virus outbreak response interventions in Bentiu IDP camp assessing epidemiological and Environmental factors in Bentiu IDP Camp to identify the source of infection, mode of spread and other risk factors for Hepatitis E Virus infection. The scope of post action review will be focused on the public health response to HEV response. The evaluation will identify best practices and document lessons learned to inform HEV responses in camp settings.

Objectives of the Endline Evaluation:

This final evaluation exercise will seek to achieve the following objectives:

1. To critically review current methods for the detection, identification, characterization, and tracing of HEV. In the case of methods for detection, special emphasis should be made to assess their application to samples from food-producing animals and foods.

2. To examine currently available information on the geographical distribution of HEV and epidemiology, occurrence and persistence in foods and consumer habits contributing to infection.

3. To assess response measures in place (Health, WASH, Environmental Health) and possible control, management and prevention measures along the food chain and evaluate decontamination treatments.

4. Document good practices and lessons learned supported by evidence from current and past HEV response interventions in Bentiu IDP camp.

Endline Evaluation Scope:

The consultant will conduct end line evaluation in all sectors of Bentiu IDP camp. The survey team members and shall conduct the endline evaluation to the required quality standards.

Sample Size:

The Consultant will determine the appropriate sample sizes considering the geographical areas, targeted groups, and the homogeneity and heterogeneity of the target population.

Methodology:

The evaluation will use a mixed method approach where quantitative and qualitative approaches will be applied. The consultant is expected to collect quantitative and qualitative data from primary and secondary sources, conduct analysis using various relevant techniques and triangulate information from various sources when presenting and discussing findings. The consultant is expected to make conclusions and recommendations based on findings. The recommendations made should be actionable and practical in the context of South Sudan. The evaluation should be utilization-focused as IRC intends to use the findings to inform current and future programming. Given this overall guidance, the technical proposals should provide detailed methodology for this assignment. Key activities should include, but not limited to:

Define the scope of the post action review (Endline evaluation) in collaboration with health cluster and appropriate county State and national stakeholders including selection of areas to conduct assessment.

Develop a detailed agenda and workplan by collecting of background information on the HEV response in the Bentiu IDP camp.

Document review of project documents including Logical framework for the project design and reports from response partners. 

Instrument development in English and orient the supervisors and field workers for the study.

Facilitate and supervise data collection within quantitative and qualitative frameworks for the study.

Consultations with relevant stakeholders at sector, national, and state levels.

Analyze data and report preparation.

Ensure that lessons learned and good practices are documented throughout the process inception report with the final research design.

Drafting report with relevant endline indicator achievement figures with factsheet and ensure that they are of good quality.

A presentation kit of main results highlighting important analysis and trends and updating the results framework.

Incorporating feedback/comments and finalization of report.

Key Deliverables:

1. Consultant will produce and submit inception report detailing evaluation design and methodology, tools, and instruments to be used in this evaluation withing 5 days after the sign of the contract/agreement. The inception report will be submitted to IRC for review and presented virtually for feedback. The final inception report will be approved by IRC after submission before allowing any survey activities to continue.

2. Consultant will produce and submit first draft endline report for review and virtually presented to IRC for comments and validation. The outline for this delivery could be as agreed in the inception report, but it should meet the survey/evaluation objectives as indicated in this TOR.

3. Consultant will develop a final report, incorporating feedback from IRC. The Consultant is accountable to maintain the requirements for the content, format, and length of the final report, overall quality and agreed timelines. Final endline report should incorporate all comments from IRC. The finalized report will be presented highlighting key findings and recommendations.

IRC Responsibility:

1.   Work closely with the Consultant in planning, coordination and execution of the assignment.

2.   IRC will support the Consultant in travel booking to the field using UNHAS flights.

3.   Induction on the IRC safeguarding policy for the Consultant and enumerators before directly engaging with the clients.

4.   Responsible for organizing meetings with the different stakeholders during the survey (if required).

5.   Introducing the Consultant to local authorities for easy execution of the survey in the communities.

6.   Provide relevant project documents for review

Consultant Responsibility:

1.   Participate in the induction to the safeguarding policy and sign the safeguarding statement.

2.   Ensure the actual survey is conducted as per the TOR and contract.

3.   Ensure the highest research ethical standards and transparency are upheld during the evaluation.

4.   Ensure that the time scheduled is adhered to.

5.   Responsible for his or her stationaries and other items needed for the evaluation.

6.   International flights/travel will be at the Consultant's responsibility.

7.  Consultancy fee is expected to cover the Consultant's subsistence needs (food, accommodation, security/allowances, enumerator fees, training). All costs related to the evaluation should be included in the consultancy fee.

8.   Consultant will be responsible to train the enumerators which is agreed as per inception report, and test the tools agreed. Refinement will be checked by IRC after field testing.

9.   The Consultant should develop data collection tools and present to IRC for approval.

10. Survey execution - according to the agreed sample size and area, beneficiary/ community, and stakeholder coverage. If possible, the data collection should be conducted with the support of Kobo Collect or CommCare and GPS to map the respondents for future reference (if possible).

 

Data Disclosure:

1. The Consultant should handover/deliver to IRC, at minimum, all files obtained during the survey including quantitative data sets (raw and refined products), transcripts of qualitative data and others in an easy to read format and maintain naming conventions and labelling for the use of the project/ program/ initiative and key stakeholders.

2. Data must be disaggregated by gender, age, and other relevant diversity, etc.

3. Datasets must be anonymized with all identifying information removed. Each individual or household should be assigned a unique identifier. Datasets which have been anonymized will be accompanied by a password protected identifier key document to ensure that we are able to return to households or individuals for follow up.

4. Stakeholders with access to this document will be limited and defined in collaboration with IRC during evaluation inception. The Consultant is not allowed to use other than for this evaluation purpose or share data, findings, reports etc of this survey, except with the written approval from IRC.

 

Work Plan:

The endline study is estimated to take 30 working days including field work and report compilation period. The evaluation will be covered from April to May 2022. The consultant will be required to submit a timely workplan of activities for this endline evaluation on proposal submission.

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