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|Overview of position||Under the current New Funding Model grant, a considerable proportion of the grant is allocated to Behaviour Change Communication (BCC). Two of the key modalities to deliver information are through Community Conversations (run through UNDP) and peer education programs (run through OSPAD, WAWA, HDC, CCS, PUNCHAD, SAHAN, BADBADO and TALOWADAG).
In the Somali context, the HIV epidemic is fuelled by structural and social factors, such as poverty, gender inequalities and human rights violations which increase vulnerabilities to HIV infection. These factors significantly determine access to information and services. Therefore, there is a need to go beyond sensitization, awareness and media campaigns to more community-based and community owned approaches, which both address underlying socio-cultural dynamics in a way that empowers people to analyse and plan against HIV&AIDS in their own communities and examines risk behaviours and how to mitigate them. ‘Community Conversations on HIV’ were introduced in Somalia to help promote the meaningful engagement of civil society in a dialogue around HIV, as well as scale up efforts to intensify prevention, treatment, care and support towards the Universal Access Targets in Somali Populations. Peer Education was introduced in this grant to specifically target key vulnerable populations (vulnerable women, clients, uniformed personnel) with tailored prevention messages through outreach, and referrals into testing.
Stigma and discrimination, rife in Somalia, restricts people from accessing HIV Testing and Counselling (HTC), Prevention of Mother to Child Transmission (PMTCT), Antiretroviral Therapy (ART) services. This was confirmed in formative research done by BBC Media Action for UNDP (2012) and the Stigma Index Survey (2107), both of which indicated while there are significant behavioural and logistical barriers to the HIV and AIDS response in Somalia, stigma and discrimination are the most significant barriers for people seeking information, testing and treatment.
Current implementation under the New Funding Model 2015 - 2017
Under the New Funding Model Global Fund grant implementation peer education is conducted through partners, some also providing clinical services, some not, some PLHIV networks, some not. The peer education programme to date has been using a 2-day peer education/information session programme. It is unclear if this modality of information sharing has been successful in reaching those most at risk given the stigma in Somalia, and also whether it has been successful in promoting HTC uptake of those most at risk.
Under the current New Funding Model Global Fund grant implementation, the United Nations Development Programme (UNDP) is undertaking Community Conversations on behalf of the Principle Recipient. Community Conversations provide an opportunity to provide the facts on HIV as well as address myths and misconceptions associated with the disease which are common in Somalia. This is expected to help people change their behaviour, both in terms of the way they behave toward People Living with HIV (PLHIV), as well as their own risk behaviour, and access HIV Services. CCs include resource persons e.g. religious leaders, PLHIV, HTC staff to talk about the benefit of knowing your status. One of the main objectives of this project is to create/strengthen linkages between communities and health services such as HTC, ART, and PMTCT. Sharing information on these services is vital in order to scale up access to these services.
Community Conversations on HIV have run in Somalia for approximately five (5) years and peer education for three years without an evaluation ever having been carried out to evaluate the impact the project has made and make specific recommendations around planned implementation of CCs in the new funding request 2018-2020.
Planned implementation under the new funding request 2018-2020
Under the new funding request (2018-2020), peer education will be delivered through outreach through peers, including peers for vulnerable women, one for vulnerable men, one to link with private sector facilities to promote HTC uptake and the men’s hotline, one for PLHIV, and 6 for IDP across the three regions. In addition, one PE will be placed at each ART facility in each region to facilitate adherence and retention. The peer educator placed at ART facilities will be responsible to track all HIV positive patients to ensure enrolment and trace lost to follow up patients. A Mother Mentor will be placed at each ART site to support mothers and develop mothers and children’s support groups. These mothers are meant to counsel other mothers on disclosure, link them to GBV services if needed, and support them to link to livelihood activities. The outreach package for both consists of a certain set of messages derived from the Peer Educator’s Toolkits (to be finalized end year 2017) and specific referrals for services. An accountable monitoring and referral feedback system will be developed to ensure clients referred for testing reach testing or are able to be tracked.
From HIV NFM grant support, UNDP has developed 3 Peer Educator manuals which have been field tested (through development) and will be finalised and printed along with the related IEC materials before the end of 2017. The packages of services for vulnerable populations includes:
Under the new funding request (2018-2020), CCs will continue coordinated by the National AIDS Commissions. They will be condensed from the current 12 sessions to a half-day session as it cannot be expected that the same people would return to subsequent conversations, however, sites may be re-visited if it high interest is determined or if subjects are not covered. Cities may contain multiple sites. They will continue to be rolled out through each region, 9 sessions per quarter, under the new funding request grant application, with the same geographical focus as vulnerable populations to increase potential HTC uptake and contribute to stigma reduction.
|Role objectives||The overall purpose of this assignment is to evaluate under the BCC component of the New Funding Model grant implementation both the current Peer Education (PE) and Community Conversations on HIV programmes in Somalia. The PE programme is being rolled out through current sub-recipients (SRs), and the CC programme through UNDP, who has been technically supporting for the last 5 years. The evaluation is to understand the impact of both programmes and provide recommendations for continued implementation of both programmes in the New Funding Request grant 2018-2020.
The key areas of evaluations are:
1. Limitations in providing PE and the CC (logistics, political, enabled environment, etc.);
2. Limitations in covering all the CC modules and the learning methods within the modules;
3. Concrete measurable impact of both the PE and the CC projects;
4. Measurable outcomes of both projects;
5. Recommendations moving forward for providing both PE and the CCs (delivery modality, logistics, political, enabled environment, etc.);
6. Recommendations moving forward to merge the CC modules into ½ day session bearing in mind the key objectives under the next grant are stigma reduction and HTC uptake;
7. Key recommendations for the National AIDS Commissions in moving the CCs initiative forward.
Methodology and technical approach:
The methodology should be the same, but the evaluations for PE and CCs are different and two different reports should be submitted at the end of the assignment.
The method of collection of strategic information will be qualitative, although the consultant should try as much as possible to understand numbers of beneficiaries reached. The Consultant will be expected to outline in their Draft work plan shared with UNICEF at the beginning of this assignment, the total sample size for questionnaires, Focus Group Discussions and interviews that they plan to carry out.
Participatory methods of data collection should be used when discussing with beneficiaries, noting that a large number of beneficiaries of this project are illiterate. Collection of strategic information should include the consultant using questionnaires, Focus Group Discussions (FGD), as well as interviews with selected partners.
Questionnaires will used to collect more general information from the NGOS implementing both CCs and Peer Education, including numbers reached.
Focus Group Discussions
The main objective of FGD will be to collect qualitative date to enable the consultant to obtain in depth information regarding the impact of the initiative, best practices, as well as lessons learnt. Focus Group Discussions for CC should include Religious Leaders as well as other Resource Persons.
People Living with HIV who participated in the CC should have their own FGD if enough people or be interviewed separately to understand the strengths and weaknesses of the CC methodology in addressing stigma.
Interviews will help to refine the quality of data collected. Interviews should be carried out with direct beneficiaries as well as with Resource Persons highlighted above, including staff from local Health Centres.
Interviews should also be conducted with the National AIDS Commissions to understand their work so far, their understanding of the CC and their ideas for coordination of this activity.
PE: The consultant will work through the NGOs providing the PE outreach, namely OSPAD, WAWA, HDC, CCS, PUNCHAD, SAHAN, BADBADO and TALOWADAG.
CC: The consultant will liaise with UNDP in Nairobi and work through the NGOs providing the CCs, including Human Development Concern (HDC) in Federal Government Somalia, Tadamun Social Society (TASS) in Bossaso, Puntland, YOVENCO in Berbera and Talawadag Network of PLHIV in Somaliand and AAWDO in Mogadishu who stopped working on CC in 2016.
|Expected output||1. Task: Develop a Draft work plan for the evaluation and share/discuss this with UNICEF HIV Programme.
• Time frame: 2 days
• End product/deliverables: Work-plan.
2. Task: Carry out a desk review of all documents, reports and other available written materials on HIV and AIDS in Somalia, noting specific challenges and opportunities.
• Time frame: 3 days
3. Task: Develop the necessary tools for data collection - questionnaires, interviews and Focus Group Discussions including online as some areas where partners work will not be accessible.
• Time frame: 5 days
• End product/deliverables: Data collection tools developed.
4. Task: Brief in Nairobi with UNICEF and UNDP- 1 day (in Nairobi)
• Carry out interviews with project partners, and focus group discussions with PE and Community Conversation beneficiaries and relevant stakeholders to evaluate results of the CC project – in 1) Mogadishu; 2) Garowe; and 3) Hargeisa.
• Carry out interviews with project partners, and focus group discussions with PE and Community Conversation beneficiaries and relevant stakeholders to evaluate results of the CC project. Interviews and FGDs to be conducted at MIA or RA in Mogadishu; GIH in Garowe and Ambassador Hotel in Hargeisa. Field visits in Hargeisa.
• Time frame: 16 working days (including additional travel days)
5. Task: Debrief in Nairobi with UNICEF and UNDP-1 day (in Nairobi)
Share with UNICEF two concise evaluation reports that includes highlighting the following – of no more than 20 pages each:
a) Specify the results achieved by the PE Project in terms of its ability to reach peers (vulnerable women, clients), to increase HTC uptake, and if at all to change behaviours and build a sense of community;
b) Assess the benefits gained in light of the results achieved and inputs required;
c) Identify lessons learned for optimizing the benefits achieved in terms of reaching peers, HTC uptake, behaviour change and community building considering the new focus of the programme as articulated above;
d) Identify vulnerable populations’ and NGO stakeholders’ perspectives of the PE process; Note: at least 2 revisions are anticipated and relevant days booked in.
a) Specify the results achieved by the CCE HIV Project in terms of its contribution to energizing communities’ response to HIV and AIDS, as well as broader development challenges;
b) Assess the benefits gained in light of the results achieved and inputs required;
c) Identify lessons learned for optimizing the benefits achieved in terms of community mobilisation, ownership and sustainability considering the new focus of the programme as articulated above;
d) Identify community and related stakeholders’ perspectives of the CCE Project and Community Conversations (CC) process;
Note: at least 2 revisions are anticipated and relevant days booked in.
• Time frame: 7 days (including revisions) to take place anywhere but to be completed by 15th December.
|Project reporting||The consultant will work under the supervision of the HIV Programme Manager|
|Key competencies||• Degree in Public Health, Social Sciences or related Technical field preferred OR Diploma in combination with qualifying experience of over 7 years may be accepted in lieu of degree.
• At least 5-7 years of relevant professional experience working with HIV and communities, including assessments and evaluations.
• Fluency in English with outstanding facilitation and communication skills.
• Knowledge of Somalia and its operational context and willingness to travel for work there.