Consultant - End of Project Evaluation for Integrated Reproductive Health and Nutrition Intervention Project in Lautem and Manatuto Municipalities

Background

With total population of 1.318.000 (WHO Factsheet 2020), Timor Leste has high poverty as of 31% and 14% of under-5 population. On maternal mortality and malnutrition, Timor Leste has one of the highest rates over the world. Several factors contributing to this is of low use of health services for births and maternal care, poorly equipped health facilities, undertrained health staff, low health knowledge of community, and poor nutritional intake especially for children under five.

Responding to this, ChildFund Timor-Leste implements a program ‘Integrated Reproductive Health and Nutrition’ in two municipalities: Lautem and Manatuto. The overall goal of the project is to strengthen the capacity of sub-national and community health systems to lead sustainable, inclusive, accessible, and quality reproductive health and nutrition services for pregnant and lactating women, parents & caregivers, children under five, and young people. Its focus is to address malnutrition for children under five, pregnant, and lactating women; next to address maternal and child health (MCH) with a focus on improving pregnancy care, post-natal care, child illness management; and adolescent sexual and reproductive health (SRH) targeting adolescent/youth of 15-24 years old.

The project also addresses the capacity of local health system especially health workers capacity in the implementation of community outreach services and the training and ongoing support to Family Health Promoters (PSF/Promotor Saude na Familia) and Mother Support Groups (MSG). Next is to strengthen the capacity of health staff and health volunteers through training, prioritizing topics such as Gender and Inclusion to improve inclusive and quality access to health services. On SRH, the project addresses the issues of unwanted pregnancies and low SRH knowledge of adolescent as well as socio-cultural taboos about sex, pressure to marry early and having children.

The project is implemented from July 2022 to June 2025, the project covered ten villages in Manatuto: Fatuwaque, Aubeon, Barique, Manehat, Uma Boco, Sikone-Diloli, Batara, Funar, Manelima and Sananain; and ten villages in Lautem: Afabubu, Baricafa, Cotamuto, Lacawa, Luro, Wairoque, Baduro, Euquisi, Ililai, Serelau.

The project has three outcomes:

1. Pregnant and lactating women, male and female caregivers have improved knowledge, adaptive behaviors and practice on maternal and child health, and sustainable nutritional practices for children under five.

2. Health service providers (CHC and HP’s) and community leaders have improved capacity attitude and resource allocation to lead the implementation of nutrition, maternal, and child health and adolescent/youth reproductive interventions.

3. Adolescents/youth have improved knowledge on SRH, respectful relationships, and are able to make their own decisions about their relationship.

Purpose of the end of project evaluation

The purpose of the endline survey is to assess the progress made towards achieving the project objectives and to evaluate the effectiveness, impact and sustainability of the project interventions. This includes measuring the community’s understanding of maternal and child health, nutrition practices, and adolescent reproductive health, as well as assessing the confidence and capacity of primary health care workers in delivering maternal and child health care and adolescent reproductive health services.

The objective of the end of project evaluation are as follows;

· To evaluate the project outcomes and measure the achievements of key performance indicators.

· To assess the progress made over the three-year intervention in 20 villages across both municipalities, identify lessons learned and providing recommendations for future programing.

· To measure the impact of the project intervention among target beneficiary on maternal child health nutrition and adolescent reproductive health. Comparing baseline and endline data to determine changes attributable to the project.

· To measure the project’s impact, align with the Childfund Strategic Alignment Paper and health the sector approach.

KEY Evaluation Questions:

KEQ 1 . To what extent did the project reach its goal to, “strengthen the capacity of sub-national and community health systems to lead sustainable, inclusive, accessible, and quality reproductive health and nutrition services for pregnant and lactating women, parents and caregivers, children under 5, and young people?”

KEQ 2 . How effective were the project’s strategies and interventions in achieving results that:

(1) Pregnant and lactating women, male and female caregivers have improved knowledge, adaptive behaviors and practice on maternal and child health, and sustainable nutritional practices for children under five.

(2) Health service providers (CHC and HP’s) and community leaders have improved capacity attitude and resource allocation to lead the implementation of nutrition, maternal, and child health and adolescent/youth reproductive interventions.; and

(3) Adolescents/youth have improved knowledge on SRH, respectful relationships, and are able to make their own decisions about their relationship.

What were the barriers and enablers that made the difference between successful and disappointing outcomes? What are the lessons that can be learnt in both ChildFund's Timor-Leste's strategic ambitions and ChildFund Australia’s health sector?

KEQ 3 . To what extent does the project advance the organisation’s strategic imperatives on locally-led development? How effective were ChildFund Timor-Leste's partnerships with its CSO partner, government, and local stakeholder groups?

KEQ 4 . How effective were the project’s strategies and interventions in advancing gender equality, disability and social inclusion? What are those that worked well and those that didn’t? What can be scaled and why? How well did these address systemic issues and what are the factors that contributed to these?

ChildFund Timor-Leste values consultants with experience in health and nutrition evaluation, preferably in the Timorese context for the study. International consultants are expected to have enumerators who speak local languages to collect data in Lautem and Manatuto Municipalities.

The selected consultant will undertake summative endline survey of Childfund’s Integrated Reproductive Health and Nutrition Intervention in Lautem and Manatuto Municipalities. The report should provide a comprehensive analysis of the findings from each Municipality, evaluating project impact and comparing the changes that occurred before and after implementation of the project, as well as to provide endline values for the project indicators.

Scope of the Endline Survey

The endline survey will take place in April 2025 which is the last quarter of the last financial year of the 3-year long project (July 2024-June 2025). The survey will be conducted in all target villages with a total of 20 villages in both Lautem and Manatuto Municipalities.

The consultant(s) should submit an expression of interest outlining appropriate methodologies to be able to meet the objectives of the evaluation. The final methodologies will be decided through a collaborative approach involving the Consultant, ChildFund Timor-Leste team and ChildFund Australia team. The consultant will work closely with ChildFund Timor-Leste staff who will be available to support the data collection, while the ChildFund Australia team will provide the technical review of the reports.

Key Tasks:

The consultant is expected to review relevant primary and secondary sources of information associated with the project proposals and design data collection methodologies/plan, focusing on maternal & child health, nutrition, and adolescent sexual and reproductive health, incorporate the analysis of gender and disability inclusion (GEDSI). The consultant will lead the qualitative data collection process, utilizing Focus Group Discussions (FGD) a