UNICEF Uganda Terms of reference (TOR) for Institutional SSA PROJECT/ASSIGNMENT TITLE: Developing econtent for pregnant women/ family and health workers WORKPLAN CODE NUMBER: Specific Intervention Code: 1.1.31 Activity: Development and roll out of CHMS / FamilyConnect Content and Content portal Objectives: 1. Development of Version 1.0 stage-based econtent for pregnant women, mothers and their households for the first 1,000 days 2. Development of Version 1.0 supporting econtent for community health workers and the public 3. Refinement of econtent development Version 2.0 Background UNICEF is providing technical assistance to the UNCoLSC, and is mandated to support the development elearning content and content management solution for Village Health Teams (VHTs). UNICEF is collaborating with the Ministry of Health to develop an electronic tool for registering and supporting expectant women and community health workers. This tool, FamilyConnect (see Annex 1) is based on the existing South African Ministry of Health tool, MomConnect. FamilyConnect will send stage-based, life-cycle econtent messages to expectant women and heads of households up to delivery and for the two years of their child, after birth. It will also provide econtent covering training protocols and other important information, to Health Workers to enable them to better support the mother. There are current efforts by UNICEF, the MoH and partners to identify, customize and development econtent. This econtent must be optimized to be available both on simple feature phones using the Unstructured Supplementary Service Data (USSD) protocol, as well as on smart phones. USSD is a commonly used menu driven option used by the telecoms to relay structured information and this familiar to any user of a basic feature phone. The purpose of this contract is to develop and / or customize, field test, optimize for digital distribution and translate the second batch of econtent into 3 languages: Luganda, Lusoga, and Runyankore working in three districts; Mukono, Kamuli and Mbarara. Note that development of the econtent is expected to be a continuous process over the next two years, and future development and translation, including into additional languages, is anticipated but not part of this contract. 1
Purpose of Assignment and Scope of work: The purpose of this assignment is to develop and / or customize pretested econtent for the MoH that can be used also by FamilyConnect, CHMS and other stakeholders. The primary target groups are pregnant women, mothers and their supporting households. These will receive targeted SMS based messages corresponding with the stages of their pregnancy and post pregnancy. Considering the limitations of SMS text, supplementary information will be provided using USSD driven FAQs and health wikis, which should are also a part of this contract and should be comprehensive in nature. These can be accessed by the target group and their supporting health workers. An integral part of the assignment is to test the econtent Development Model developed by UNICEF and measure its effectiveness in guiding the econtent development process. In addition to this are to identity and develop the supporting documentation. This Model will be used to facilitate subsequent econtent development efforts as well as outline the costs involved. The econtent that will be developed will be stored in a central searchable repository (including via USSD search engines) managed by the MoH and will be accessible to all stakeholders and partners who can build on these and provide further translations. Further details are available in the Content Development Guide in Annex s 1-3. A Content Working Group has been setup at the Health promotions department in the MoH and will support and guide the Content team and partners throughout this process. They will also assist in validating the econtent development methodologies and resulting material. Deliverable: 1. Conduct relevant content landscape analysis, both in Uganda and well as internationally. Hold Inception workshop with UNICEF, MoH and relevant stakeholder, to finalize the Content Framework (with prioritized needs), application of theories of change and work plan (April 2016) 2. Develop and /or customize, pretest and receive MoH sign-off for econtent for pregnant women and households, and supporting information for public and health workers. Refer to Annex 1, 2 and 3 for minimum requirements for the econtent. Provide approved content to Praekelt Foundation to upload into FamilyConnect (April - June 2016) 3. Develop and/or customize, pretest and receive MoH sign-off for econtent for heads of households and other user groups defined in Annex 2, finalize all content not prioritized under Deliverable 1 and completed under Deliverable 2, and provide supporting information for public and health workers for the FAQ as defined in Annex 1 and 3. Provide content to Praekelt Foundation to upload into FamilyConnect (June - September 2016). 4. Report on refined econtent Development Model with supporting documentation (August 2016) 5. Analyse data and conduct user centered feedback. Review and refine content as required. Share and disseminate the content through appropriate channels. (October 2016) 2
Methodology Development of content should be phased, starting with reproductive health and pregnant mothers, before moving to other key RMNCH content areas. The Minimum Requirement on econtent (Annex 1), FamilyConnect Draft Health Content Framework (Annex 2), and sample content from South Africa NDOH MomConnect HelpDesk (Annex 3) should be used to guide the work. Existing content should be used if possible, rather than developing new content. Organizations like mpowering Frontline Health Workers have done significant work with this mapping. All work developing new or customizing existing content must be licensed under a creative commons open-source license, and fed back into global repositories like the mpowering Orb recently set up. All content must be approved by the MoH. All activities are expected to be carried out in close collaboration with appropriate MoH officials and relevant governance structures including Technical Working Groups, with approval and sign-off prior to initiation of any work by the econtent Working Group. The District Health Teams should be co-opted and will be expected to provide the initial validation of allmaterial developed. The CWG will make the final validations. Technical assistance may be available from Babycenter and Makerere School of Languages (for translation). If the use of other external technical assistance is needed, this must be rationalized and justified, particularly if technical support is required from non-ugandan based individuals or organizations. Preference should be given to utilizing resources in-country whenever possible, with priority to leveraging or building capacity of MoH staff and other local institutions to develop and maintain these interventions for every activity in the scope of work above. A strong maintenance and support, capacity building, and handover plan should be included in the proposal. With guidance from UNICEF, the Agile methodology will be used to facilitate rapid development and field based user centered testing. Costing in the proposal for all non-national level activities should include estimates for adding additional generic Districts as well as total cost for national scale-up. Responsibilities: The company shall send updates, against their work plan, every two weeks to UNICEF and report routinely to the MoH econtent TWG Timing: It is expected that this work will be completed within a period of 7 months. Reporting requirements: Submission of electronic copy of monthly progress reports, minutes of meetings, and deliverables. 3
Qualification Requirements: The organization (or key individuals within the organization) should have: At least 3 years experience working in the area of Reproductive, Maternal, Newborn and Child Health (RMNCH). At least 3 years experience working with Community Health Worker programmes as well as developing systems to strengthen outcome and performance monitoring. At least 3 years experience working with Health Management Information Systems, ideally including the ehealth / mhealth platforms used in Uganda such as Mother Reminder. At least 3 years experience developing C4D behavioral change messaging. Practical knowledge of various Theories of Change deployed in the behavioral change Experience scoping, user testing and training for ICT4D related projects Experience in conducting field based, user centered design Experience developing and deploying SMS and USSD based solutions and other low-bandwidth applications in challenging work environments. Experience working with the MoH and OPM preferred. Proven ability to conceptualize, plan and execute ideas as well as to transfer knowledge and skills. Work experience in Uganda preferred. Proven ability to manage relationships with UNICEF s partners, including Ministry of Health, UN organizations, NGOs, academic institutions, and the private sector. Expected Budget for the Consultancy and Terms of Payment Payment will be made upon successful completion and review by UNICEF of each deliverable. The order of submission for each deliverable may be adjusted upon approval by UNICEF. Payment for each deliverable will be as follows: Deliverable 1 (10%) Deliverable 2 (20%) Deliverable 3 (35%) Deliverable 4 (10%) Deliverable 5 (25%) Administrative issue; The financial proposal should include detailed, line-by-line activities broken down to individual unit costs. No percentage based, indirect costs or overhead should be included in the budget. The technical proposal should provide a clear organizational summary providing details on how the company meets each qualification requirement, including experience on similar programmes. CV s of staff members intended to work on this project can be included. 4
Annex 1: MomConnect / FamilyConnect Overview Based on MomConnect South Africa, which was initially developed and piloted in Kwazulu-Natal province with support from UNICEF to create demand for, and improve supply of, maternal health services across South Africa. MomConnect was later scaled by the National Department of Health (NDoH), with funding from Elma Foundation, Johnson & Johnson, and the US Government. During Q2 2015, UNICEF supported a learning exchange between the Uganda MoH and the South African DNoH. As a result of this visit, the Ugandan MoH formally requested UNICEF assistance to transfer and localize MomConnect to the Uganda context under the existing CHMS programme. Notably, the Ugandan MoH recommends shifting the primary focus from Health Facilities to the community level, and allows future expansion of interventions to target the entire household, not just the mother. A few key lessons learned from the South African experience include the importance of strong content appropriately localized and contextualized for specific audience, and the potential demand for and high level of human resources required to operate a Help Desk at national scale. Target Users At the household level, FamilyConnect will not only target pregnant mothers but also the heads of households who often make critical decisions on the healthy practices of their partners and control the finances needed, for example, to travel to health facilities for ANC visits. Research conducted by the UNICEF C4D team indicates that only 21% of male partners have knowledge of the benefits of RMNCH interventions, including ANC visits, birth preparedness, facility based deliveries, early initiation of Breastfeeding, maternal nutrition and immunization. 5
The overall vision of the MoH for FamilyConnect will contain the following core components: 1. Pregnancy Registry: When a pregnant woman is identified by a VHT or reports for her first ANC visit, she will be registered by either the CHMS Android or FamilyConnect USSD registration menu to register the woman into a national client registry and grouped by household. Additionally, self-registration by mothers will also be developed. The information initially collected includes Expected Delivery Date 1, Language preference, ID where available 2, and mobile phone number. Additionally, members of the household including fathers will be registered where possible. 2. Life Cycle Based Messages: Based on the stage in a woman s pregnancy she and when not possible the head of household will receive targeted SMS messages from the date that she signs up until her baby is two year old. These messages are anticipated to available in at least 6 languages. 3. Service Rating: Mothers will periodically be asked to rate the services they are receiving at their clinic and from their VHTs. This is expected to be considered for inclusion in the national RMNCH community scorecard, and will provide a key measure for client satisfaction that will be used to advocate for, and hold service providers accountable for, quality services. 4. HelpDesk: All VHTs, Mothers and heads of households can reply to any of the messages they receive with questions, compliments or complaints. These will be forwarded to a central Helpdesk established at the MoH in 2013 3, where MoH staff will use a set of pre-written and approved responses to reply. All compliments and complaints will forwarded to district point people who have 2 weeks to respond to these compliments or complaints. Under the MoH s ehmis programme, successful District response to complaints averaged around 70% between 2013-2014. 5. USSD FAQ s: Additional health information will be available via pre-populated USSD menu s (about popular topics like labour, birth, HIV, breastfeeding, etc.) that are browsable on all basic mobile phones and does not require a data connection, greatly expanding access to health information. Responses will be sent back via SMS. This service and related content will target both VHTs and pregnant mothers / heads of households. 6. System-wide Integration The MoH is taking a systems level, standards based approach to development and integration of FamilyConnect based on best practices coming out of the OpenHIE and International Organization for Standardization (ISO) communities 1 VHTs are currently registering into a paper logbook and estimating expected Delivery Dates from the last menses period. This process will be automated through FamilyConnect, removing some of the potential calculation errors. Linkages with the national Vital Registration System / Birth Registration and the National ID will help ensure the database is as accurate as possible. 2 FamilyConnect is being designed to anticipate integration within these national systems regardless of their current coverage. it as part of the FamilyConnect solution. 6