Terms of Reference for Institutional Consultancy Handwashing with Soap Programme-HWWS in Myanmar Section in Charge: YCSD section, WASH Unit 1. Purpose of the Assignment: 1.1. Background: Handwashing with soap has the capacity to reduce diarrhoeal infections by up to 40% (1), respiratory infections by 23% (2) cut neonatal mortality (3) and help prevent malnutrition (4). Hand hygiene prevents absenteeism in schools (5), is often an intervention of choice in the case of epidemics, for example of influenza, SARS and Ebola, in disaster response (6) and is important to prevent the spread of antibiotic resistance in homes and in hospitals(7) (Source: Environmental Health Group, London School of Hygiene and Tropical Medicine, Oct 2012). All of these issues are pertinent to Myanmar which, in 2015, had an infant mortality rate of 46/1000, a 1/250 rate of maternal death and a substantial burden of infectious disease (respiratory infections accounting for 13% of child deaths and diarrhoea for 7%) and well as high rates of stunting (35% in 2015) (Source: Countdown to 2015). This poor health situation is improving and recent political changes give cause for optimism that renewed efforts will be targeted at the health of the poorest and most marginalised groups in society. In the meantime, handwashing with soap remains effective, available and affordable, but is not getting the sustained investment and programming attention that it deserves. UNICEF has a long history of supporting the Myanmar Government on strengthening systems to support child health and education, WASH, nutrition, maternal health and disaster mitigation. Each of these sectors have some components that concern hand hygiene, however, thus far, efforts have not been joined up. The same is true of all partners investing in health improvement in Myanmar; partners support, in principle, the need to improve hand hygiene in homes, in schools and in health facilities, but there is no one overarching effort to achieve better handwashing. Myanmar has seen several previous programmes that have promoted hygiene. Children well know the Thant Shin campaign in association with Global Handwashing Day, the WASH in schools programme and the Red Cross. The Department of Public Health s Health Education Division also promotes the Four Cleans : food, water, hands and toilet. These have created some community awareness and lessons can be learnt from these efforts. Handwashing promotion also forms part of the current CLTS programme that is supported by UNICEF across Myanmar. Many toilets constructed through this programme include handwashing facilities. Handwashing is also a part of midwife training, and soap forms a part of the clean birth kit that mothers are expected to obtain. However, WASH facilities in health centres are known to be patchy, as they are in schools. The largest scale current effort on handwashing is the Life boy School of Five programme. This has two arms; a schools programme that has to date reached 4 million people and targets reaching 20m people by 2020, and a midwife payday handwashing training programme. Hand hygiene is the simplest, cheapest and most effective measure for preventing diarrhoeal disease. Despite the simplicity of this procedure and advances made in infection control and health promotion, and improvements in knowledge about the importance of hand hygiene, rates of actual hand hygiene practice remain low around the world as well as in Myanmar. In order to prevent diarrheal diseases and promote hand washing practices at critical times, UNICEF would like to use the contextualized approach for the design of achieving a more coordinated, focused and perhaps a national approach to increase handwashing with soap/ a high impact hand washing intervention for Myanmar. Therefore, this will require carrying out assessment visits to meet with key stakeholders including Department of Public Health, UNICEF, desk review of literature relating to hygiene practices and program in Myanmar, conducting
framing workshop with stakeholders to identify the knowns and unknowns of key hygiene behaviours and messages with focus on handwashing with soap, formulation of formative research design and designing and carrying out in depth Formative Research in households and health centres in Magway and Ayeyarwaddy Regions using a range of qualitative and quantitative tools. This will include to extract key insights hygiene behaviours on handwashing with soap from mothers and caregivers of children under 3, and/or first 1000 days, and construct a theory of change. After that, process monitoring and behaviour monitoring of the HWWS programme will be done by using appropriate research methodologies in order to develop a nationwide HWWS roll-out plan. There will be two phases to deliver the programme. Phase 1 covers the steps necessary for formative research and intervention design, piloting and finalisation. This will be followed by a period of implementation by the Myanmar government. Phase 2 covers behaviour change monitoring and assessment. 1.2. Purpose: The purpose of this work is to design an effective intervention to promote handwashing with soap across rural Myanmar. The intervention is expected to target the mothers and caregivers of young children that include children under 3, and/or first 1000 days and possibly midwives, although the exact audiences will be finalized based on the findings of formative research. Specific Objectives Phase I To conduct assessment visits, desk review of grey and published literature relating to hygiene practice and hygiene promotion with focus on handwashing with soap in Myanmar and designing workshop with key stakeholders to identify research areas To conduct formative research based on the designing workshop and desk review, to understand and observe key drivers, barriers and context of handwashing behaviours in homes and institutions To develop an 18 months behaviour change intervention to promote handwashing with soap to include o Key audiences and messages addressing barriers and highlighting the key benefit of handwashing with soap based on the findings from formative research o Creative approaches and communication channels to reach and promote desired behaviours Phase II To develop a monitoring framework to assess process and behaviours of the HWWS intervention To develop a nationwide HWWS roll-out plan based on the review and assessment results 2. Programme Area and Specific Project Involved: This activity will contribute to achieve the following result areas: Programme Outcome 103: Water and excreta related diseases in under-5 children are equitably reduced. Output 001 (WASH Policy, Standards and guidelines): Evidence-informed policies, standards and guidelines developed and implemented to build and sustain hygienic and healthy living conditions for women and children in Myanmar. MYWP Activity # 103.001.003 Support studies and surveys related to WASH (such as Mensural Hygiene Management, KAP Survey, Sanitation Marketing, etc.) Output 002 (WASH practices promotion): Targeted rural communities in dry zone, conflict affected children and women in Mon and Kayin states practice key hygienic behaviour (consistent use of toilet, stop open defecation practice, hand washing with soap at critical times and drinking safe water). 2
MYWP Activity# 103.001.003 and 103.002.001 Support studies and survey related to WASH Promote handwashing, proper use of latrines and safe water handling at national and subnational level through multi-channel media campaigns More specifically, the institutional consultant will help to do process monitoring and behaviour monitoring with a before-after controlled trial (BAC) or similar. The programme will include field work involving structured observation of handwashing behaviour. At the same time, a concurrent process monitoring and assessment will allow the determination of what did and did not work well. Results of the research and field work will be fed back to stakeholders, and the programme improved and scaled up. 3. Basic Programme Objective Related to Consultancy Basic programme objective - Water and excreta related diseases in under-5 children are equitably reduced through having improved sanitation and hygiene in targeted rural communities. 4. Major Tasks to be Accomplished: The consultants will review handwashing with soap-hwws materials and literature, technical documents and existing reports to collect information on previous handwashing programme implemented by government and all development partners in Myanmar, design and carry out indepth formative research to observe key handwashing behaviours and to construct theory of change in one Township of Magway Region and one township of Ayeyarwaddy Region (places to be confirmed after consultation with Ministry of Health and Sports). The primary focus of the programme should be: Mothers of young children under 3, and/or first 1000 days, living in rural areas Midwives and Public Health Supervisors II (PHS II) at rural health stations The specific tasks are as follow: 4.1 End product(s), delivery dates and details: The work will be done in two Phases. Phase I will be designing and conducting formative research and creative brief and process, setting up and delivering HWWS programme intervention and phase II will be monitoring and assessing the process and impact of HWWS programme after phase I is successfully delivered. The deliverables expected from handwashing with soap-hwws programme consultants include: Activity Phase 1: Designing workshop and Formative research Task 1.1: Assessment visit and desk review Assessment visit including meeting with UNICEF and other key stakeholders. Desk review of grey and published literature relating to hygiene practice and hygiene promotion in Myanmar Task 1.2: Designing workshop Conduct Designing workshop with key stakeholders to summarize what is known about how change can be achieved and then to set out hypotheses about change mechanisms for further exploration (UNICEF will arrange/pay workshop cost) Task 1.3: Formative research design and research Design and carry out two weeks of in depth Formative Research in households and health centres in Magway and Ayeyarwaddy using a range of qualitative and quantitative tools 3 Expected Outputs/ Deliverables a. Field visit reports submitted b. Summary report of desk review of literature c. Workshop report including knowns, unknowns of behaviour change on handwashing with soap and questions for formative research identified d. In consultation with key stakeholders, formative research design (research plan) prepared e. HWWS formative research design approved by ethic Timeframe 10 days 10 days 20 days
Extract key insights including but not limited to practices, barriers, social norms and enablers of handwashing with soap, and construct a theory of change Task 1.4: Develop HWWS intervention design and materials based on the findings from formative research Establish a small working group of Ministry of Health and Sports (MoHS), UNICEF and key partners to work with them to design a high impact HWWS intervention package Identify resources to develop creative brief of high impact HWWS intervention design and a package of materials Write and brief creative brief for local creative agency Brief a local creative agency of the HWWS design and package. Work with creative agency and key stakeholder group to develop concepts and draft materials in close collaboration and discussion with working group Task 1.5: Deliver HWWS intervention Set up HWWS intervention package Deliver HWWS intervention package that will include multilayered communication channels to the target population for the intended impact in Magway and Ayeyarwaddy Regions by one local NGO in close coordination with Department of Public Health. (UNICEF will hire implementing agency/institution for the implementation of interventions) Provide technical support to local implementing agency or institution, creative agency and key stakeholder groups to deliver the HWWS intervention - develop concepts and draft materials - field testing concepts and materials - revise concepts and materials - field testing revised concepts and materials - finalise intervention content and design Provide required support when obtaining approval from MoHS on proposed concepts and materials as necessary. Oversee and guide the whole intervention process together with MoHS and UNICEF. This one can be done outside Myanmar Total days for Phase 1: Phase 2: Process and Behaviour Monitoring Task 2.1: Process and Behaviour Monitoring and Assessment of HWWS intervention with a before-after controlled trial (BAC) or similar after the intervention is successfully delivered (6 months intervention set up to delivery or more) Review and assess the whole process for the determination of what did and did not work well concurrently in order to feed the results back to stakeholders and to improve and scale up the programme Based on the review and assessment results, prepare a nationwide HWWS roll-out plan Total days for Phase 2: Total days for Phase 1 and 2: review board committee Myanmar f. Formative research for HWWS programme carried out in Magway and Ayeyarwaddy g. A small working group of MoHS, UNICEF and key partners established h. Creative brief for a high impact of HWWS intervention developed and approved by MOHS i. Creative agency was briefed about HWWS design and package j. HWWS programme set up and delivered in Magway and Ayeyarwaddy Regions by MoHS with support from one agency/institution and other stakeholders k. Field monitoring report submitted l. Field testing completed and the concept and materials revised/finalized after field testing m. Intervention content and design completed n. HWWS programme final review report developed and published o. Process monitoring report developed p. Behaviour monitoring report developed q. A nationwide HHWS rollout plan including detail work plan with clear M&E plan, revised ToC, clear description of roles and responsibilities of concerned / key parties prepared 15 days 45 days 100 days 120 days 120 days 220 days 4
5. Contract Supervisor and frequency of performance reviews: Under the guidance of Chief of YCSD section, the WASH Specialist (international) will supervise the Consultancy work and the WASH Specialist (national) will assist the supervision works. 6. Work Place: The selected institution will be based at the UNICEF Country Office and visit to the Ministries as required. Office Space: Yes but limited to maximum of 2 persons will be allowed to use office space in Yangon as and when needed. Transport to the field: The institution will be responsible for arranging local transportation. Computer: Consultants will use their own computers. 7. Estimated duration of contract: Duration of Contract: 220 working days over 18 month period - starting July 2017 (Phase I (one year) and Phase II (6 months) will be commenced once Phase I is completed. 8. Official Travel involved, if any: Consultants will need to travel to UNICEF intervention areas such as Bogalay in Ayeyarwaddy Region and Pauk or Myaing in Magway Region. The objective of the field visit will be to carry out in-depth formative research to observe key handwashing behaviours, to construct theory of change and to monitor the delivery of a high impact HWWS intervention. 9. Payment schedule The proposed payments are made in 4 instalments. Ref Deliverable % Payable 1 Conduct assessment visits, carry out desk review of 20% hygiene related documents and conduct designing workshop (Task 1.1 and 1.2) deliverables a to c 2 Formative research design and carrying out in depth 20% research (Task 1.3) deliverables d to f 3 Develop creative HWWS intervention design and a package of materials (Task 1.4) deliverables g to i 4 Deliver and monitor HWWS intervention (Task 1.5) deliverables j to m 20% 40% Total Budget 100% UNICEF will make direct payments if a vehicle is hired for the field trips. Consultants will make their own arrangements for their local transport in Yangon. UNICEF will provide access to the existing handwashing with soap programme documents, literature, photographic and graphic records / archives as appropriate for the work and as approved. 10. Qualification or Specialized Knowledge/Experience Required: The institution can decide whether it provides its own staff or recruit qualified consultants but the team members (one team leader, one mid-level professional team member and one junior-level team member) should meet the following requirements: 5
Description Education Experience Team leader Advanced university (PhD preferred) degree such as Public Health, Social Science, Anthropology, Sociology, Behavioural Science or other related field. Team member (mid-level professional) Team member (junior-level professional) Advanced university (MSc/MA) degree such as Public Health, Social Science, Anthropology, Sociology, Behavioural Science or other related field. A first university degree in Public Health, Social Science or other related field with a relevant combination of academic qualifications and experience may be accepted in lieu of advanced university degree. Minimum 7 years of work experience of managing, evaluating and implementing behavioural change communication programmes - specific handwashing with soap experience highly desirable. Technical knowledge of latest theories, principles and methods associated with communication for development and behavioural change communication programmes Relevant working experience in community based approaches to sanitation and hygiene, with experience in conducting research, documentation and publishing Negotiating, facilitation, management/ team management, communication and advocacy skills Minimum 5 years of work experience of evaluating and implementing behavioural change communication programmes - specific handwashing with soap experience highly desirable. Technical knowledge of theories, principles and methods associated with communication for development and behavioural change communication programmes Relevant working experience in community based approaches to sanitation and hygiene, with experience in conducting research, documentation and publishing Negotiating, facilitation, communication and advocacy skills Experience in close supervision, monitoring and quality control of field implementation work Minimum 2 years of work experience of evaluating and implementing behavioural change communication programmes - specific handwashing with soap experience highly desirable. Technical knowledge of theories, principles and methods associated with communication for development and behavioural change communication programmes Relevant working experience in community based approaches to sanitation and hygiene, with experience in conducting research, documentation and publishing Experience in close supervision, monitoring and quality control of field implementation work Good knowledge and skills especially use of Microsoft office, data management programmes, designing tools and programmes. Note: UNICEF will ask the consultancy firm to provide a technical proposal including proposed methodologies, timeframe, qualification of proposed team members, etc. Language requirements: The international team member (s) shall have excellent English language skills. Additional requirements: The consulting firm should provide company profile which should include the following: Previous work samples that are relevant to this assignment; Professional resume of the proposed candidates who will undertake the consultancy works; A cover letter expressing interest in the work which is signed by authorized person of consulting firm. The cover letter should indicate relevant experience, availability and daily rate; A brief 1-2 page work plan outlining the consultant s interpretation of this TOR with 6
suggested modifications/improvements as appropriate. 11. Additional Guidelines: A detailed plan for the deployment of human resources to carry out the tasks identified above should be included for completion of this short-term intensive study in time. Delays or violation of contractual agreements will not be acceptable. The consultants will work with support of WASH staff from UNICEF Yangon. A proposed budget should be included with breakdown of costs associated with major tasks. 12. Recourse: UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/outputs is incomplete, not delivered or for failure to meet the deadlines. 13. Evaluation Criteria The evaluation criteria of the proposal are as follows: Overall response 1. Completeness of administrative requirement 2. Completeness of technical requirements Criteria Points Unit of analysis Experience of Company/Institution and Key Personnel 3. Proven experience in providing similar services to Government Ministries, other Organizations (reference to similar contracts) 4. Team Leader (relevant experience, qualifications, certifications) 3 5 10 12 Conformity with Section 1 Procedures RFPS (1 point) Completed RFPS-Form, page 2 (1 point) Copy of valid business license provided (1 point) Overall conformity and clarity of the proposal, including appropriate referencing and supporting documents (description of institution and key personnel, previous clients, time schedule/ workplan, research methodology, references and written sample) (max 5 points) Information on similar activities having been undertaken by the company, institution or team of individuals going to be involved in this assignment (max 5 points) Information on dealing with similar Government Institution and working together with local relevant authorities. ( max 2 points) Recent and current contracts with similar agencies (UN, INGOs) (max 3 points) Number of years of relevant professional experience (max 4 points) Experience as team leader or project manager (max 3 points) Number of similar works/surveys done (max 3 points) Qualifications/certificates (max 2 points) 5. Other Key Personnel (relevant experience, qualifications, certifications) 10 Numbers and respective years of relevant professional experience related to evaluation (max 3 points) Relevant technical expertise in data analysis and tabulation and report writing (max 3 points) Composition of teams (Number of enumerators per team) (max 3 points) Qualifications/certificates (max 1 points) Proposed Methodology and Approach 6. Description of the proposed process for data collection, analysis and report writing 20 Description of the proposed process for data collection, analysis and report writing including team leader, methodology and tools to ensure the quality control on data collection (max 5 points) Match between the proposed approach and requested scope of work (max 5 points) Described in detail the process of the field work, data analysis and tabulation and report writing (max 5 points) Information on the need and recognition to cooperate with the Ministry of Health and Sports officials and local governments ( max 5 points) 7
7. Timeframe 5 8. Potential constraints considered Sub-Total (average) 70 Price Proposal Criteria 5 Sub-Total 30 TOTAL 100 Adherence of the proposed timeframe and workplan to the ToR (max 3 points) Adherence to all the milestones outlined in the ToR (max 2points) At least 2 considerations outlined (max 2 points) Description of the process and procedures to deal/mitigate these constraints (max 2 points) Reference to additional resources which can be made available for the project (max 1 point) Only proposals which receive a minimum of 50 points will be considered further. Total costs (in USD) The maximum score assigned to the price proposal (i.e 30 points) will allocated to the lowest priced proposal. All other price proposals receive scores in inverse order. 8