Evaluation of UNFPA LARC Project at Marie Stopes

Background
With an estimated population of nearly 170 million, a fertility rate of 5.7% and estimated maternal mortality of 545 per 100,000 births, Nigeria ranked as one of the worst places in the world to be a mother, according to the 2011 Report on the State of the World’s Mothers. Family planning is known to be one of the most cost effective interventions in public health and has the potential to reduce poverty and avert up to 30% of maternal deaths and 10% of child deaths[1]. Increased use of FP leads to healthier birth spacing[2] and reduces mortality and morbidity associated with pregnancy. In Nigeria, on average, 10.5% of women use a modern method of family planning whereas 20% of women have an unmet need for family planning.[3] Of the 10% of women who are using family planning, less than 10% are using permanent or long-term methods.

It was against this background that UNFPA provided funding support to the government of Nigeria through the Federal Ministry of Health (FMoH) with MSION as a “Technical Implementing Partner” to create a LARC competency based training model, and then work with State Ministries of Health (SMoH) to build public sector capacity for LARCs in the states through identification and training of select Master Trainers and Service Providers as well as Supportive Supervision for delivery of LARCs services in the project states. The objectives of the project were:

Develop a competency based curriculum to build capacity of existing public sector healthcare providers in LARC provision.

Build capacity in the competency based LARC training curriculum at State level and facilitate rollout of pilot training to 100 service providers in each of the focus States

Implementation of the project began in 2013 with an inclusive process of developing a Competency Based LARC Manual for Training Doctors, Nurses and Midwives as well as cascaded trainings of MTs and Service Providers in six (Cross-River, Ebonyi, Kaduna, Kebbi, Lagos and Ondo) states. In 2014, six additional states (Adamawa, Bayelsa, Ekiti, Enugu, Kwara and Sokoto) were included.

Justification
This evaluative study is premised on the need to assess the level of achievement of objective 1 of the project. With nearly seven hundred public sector providers trained on delivery of LARCs in 12 states across the country, using the LARC Manual (a key project output), it is critical to critically examine how development and use of the LARC manual has impacted on efforts to build capacity and scale-up delivery of LARC services through the public sector in Nigeria and thus contribute to available body of evidence on best practices/strategies for engaging the public sector to deliver quality LARCs as part of broader efforts towards attainment of the government’s target of a national CPR of 36% in 2018.

It will also provide MSION with valuable information on her contribution Family Planning service delivery in Nigeria, lessons and recommendations on best approaches to engage government at national and state level as well as other key stakeholders in the Nigeria FP landscape.

Overall Objective
The overall objective of this consultancy is to conduct an Assessment of Objective 1 of the UNFPA supported Project implemented by MSION; DEVELOP A COMPETENCY BASED CURRICULUM TO BUILD CAPACITY OF EXISTING PUBLIC HEALTHCARE PROVIDERS IN LONG ACING REVERSIBLE CONTRACEPTION (LARC) PROVISION.

Scope and Methodology
This consultancy will involve literature review of existing relevant documents as well as conduct Key Informant Interviews (KIIs) with relevant government officials at national & state levels, funders, implementing partners, and other key stakeholders/individuals within the family planning landscape in NigeriThe study will adopt a qualitative research method to explore how LARC capacity building has improved in Nigeria due to development, pilot and adoption of the Competency-based Approach to training of public sector providers.

Specifically, the consultant will be required to:

• Conduct a literature review of available body of evidence on approaches to LARC capacity building in Nigeria, pre and post development of the Competency-based LARC Manual
• Conduct Key Informant Interviews with relevant government officials (FMoH, SMoH, NPHCDA, SPHCDAs, funders, implementing partners, individuals)
•  Draw conclusions, based on findings on contribution of the Competency-based LARC Manual to public sector capacity building for LARC in Nigeria

Duration
The consultancy period if for twenty (20) days between November and December, 2016.

Reporting
The consultant will work under the direct supervision of the RM&E Manager and the UNFPA Project Manager.

Expected Outcome and Deliverables

• The consultancy service to be provided under this ToR is expected to yield the following deliverables:
• Report of desk review of available body of evidence on LARC Capacity building in Nigeria before 2013
• Report of Evaluation of Outcomes resulting from Implementation of Objective 1 of the UNFPA SENDFUN Project (key milestones, lessons learnt, gaps and recommendations for improvement)

Competency and Expertise Requirements

• The consultant should have at least a first degree in social science/communication and a minimum of 10 years cognate experience. A masters degree in public health, health promotion, communication will be an added advantage. The consultant also needs to have the following:
• Substansive knowledge and experience of the family planning landscape in Nigeira – policies, programs, socio-cultural and contextual issues that impact on FP
• Experience in designig and conducting qualitative researches aimed at evaluating program impact
• Proven ability to engage key government functionaries and keen understanding of key players within the FP landscape
• Excellent communication and presentation skills, particularly in facilitating individual and group processes
• Excellent leadership and organisational skills
• Excellent english writing skills