Fresh Jobs at John Snow Incorporated (JSI)

Background

• The World Health Organization (WHO) describes self-care as ‘the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider”. Nigeria was one of the first countries to adapt the WHO Consolidated Guideline on Self-Care Interventions for Health, in support of its goal towards universal health coverage.
• The National Guideline on Self-Care in Sexual, Reproductive and Maternal Health in Nigeria outlines four intervention areas relevant to self-care.
• These include Maternal Health, Family Planning and Infertility, Safe Abortal Care, Combatting Sexually Transmitted Infections (including HIV, reproductive tract infections), breast cancer screening and other gynecological morbidities. In addition, the Guideline contains a costed implementation plan to guide its execution across four thematic areas.
• Measurement of self-care interventions in SRMH is critical to monitoring progress and strengthening the evidence base for effective programming. This is especially important considering the need to extend quality of care outside the formal health system. The Self-Care interventions covered by the National Self-Care Guideline have benefited from varying levels of programmatic support. As such, the indicators to support these interventions are also at varying development stages.
• JSI is looking for a Consultant to support the Federal Ministry of Health in the development of a self-care monitoring framework for Nigeria.
• This will be conducted with the aim of building consensus on priority indicators to be tracked, in line with the range of self-care interventions covered by the National Self-Care Guideline for SRMH.
• The ideal candidate/organization will have a strong background in monitoring, evaluation and learning, public health, and good understanding of the policy and service delivery environment as it relates to self-care in sexual, reproductive, and maternal health programs in Nigeria.
• In addition, the consultant must have proven experience in developing monitoring and evaluation plans for public health programs in Nigeria, an in-depth knowledge on data management systems relevant to the sexual, reproductive, and maternal health programs in Nigeria and ability to engage in user consultations with stakeholders across relevant ministries, agencies, donors, and other organizations.

Goal

• To develop a robust monitoring framework for SRMH Self-Care in Nigeria, which will serve as a practical, adaptable resource for self-care stakeholders engaged in monitoring and evaluating SRMH self-care programs.

Objectives

• Work with multi-level stakeholders in the public and private sector to gain consensus on the indicators to be included in the monitoring framework for SRMH Self-Care in Nigeria.
• Develop a monitoring framework for Self- Care, in collaboration with other stakeholders relevant to SRMH programming in Nigeria.
• Categorize data sources to aid in determining the best route of data collation/collection (DHIS, NHLMIS, UNFPA MICS survey, NDHS etc).
• Provide recommendations for how to support the integration of data collection on self-care into data collection systems, with the aim of improving harmonization of the tool across the intervention areas.     

Specific Tasks and Responsibilities
In close collaboration with the Director/Head Reproductive Health Division, Family Health Department, FMOH and any other officer/person so designated by the Director, carry out the following tasks and responsibilities:

• In-brief with FmoH counterpart and self-care stakeholders to clarify expectations, share self-care vision, guideline and priorities in line with the national guideline on self-care for SRMH.
• Develop and obtain consensus on the criteria for indicator selection based on feasibility of data collection, availability of reporting mechanism and relevance to monitoring progress in support of the self-care agenda. 
• Identify indicators from the global SRMH self-care measurement tool and other relevant resources that have been prioritized for adaptation/inclusion in the monitoring framework.
• Clearly delineate and document the limitations and risks with collecting the selected indicators.
• Conduct a desk review to identify and obtain all other relevant information on existing data sources, means of verification and targets for measuring self-care interventions across public and private sectors in Nigeria.
• Develop and apply a tool to document feedback from user consultations with stakeholders across relevant ministries, agencies, donors, and other organizations.
• Collaboratively develop a self-care monitoring framework based on priority indicators agreed upon by national stakeholders.
• Facilitate meetings with relevant stakeholders to:
  • Validate the measurement framework tool.
  • Presentbarriers and recommendations to the integration of data collection of self-care indicators into routine health data systems.
• Routinely check in with JSI and FMOH counterparts to provide progress updates, plan for meetings etc.
• Develop a report that clearly articulates:
  • Method and approach to developing the measurement framework.
  • Feedback from consultative meetings
  • The scope and intervention areas that are covered by the measurement framework.
  • Limitations of the tool.
  • Barriers and recommendations to support expansion of the tool to include other data sources/intervention areas.

Key Deliverables

• In-brief meeting with FMoH and relevant stakeholders (agenda, participants list, documented notes with any agreed next steps).
• List of Criteria for Indicator Selection developed following consensus from stakeholders.
• Harmonized list of indicators obtained from the global self-care measurement tool and other resources that have been prioritized for adaptation/inclusion in the monitoring framework.
• Results of desk review detailing relevant information on existing data sources, means of verification and targets for measuring self-care interventions across public and private sectors in Nigeria.
• Documented feedback from consultative meetings
• Documented feedback from validation meetings.
• Routine check in meetings with JSI and FMoH counterparts (agenda, participants list, documented notes on progress updates and any agreed next steps)
• An approved monitoring framework for Self-Care that has been validated by national stakeholders and approved by the Federal Ministry of Health.
• A report that clearly articulates:
  • Method and approach to developing the measurement framework.
  • Feedback from consultative meetings
  • The scope and intervention areas that are covered by the measurement framework.
  • Limitations of the tool.
  • Barriers and recommendations to support expansion of the tool to include other data sources/intervention areas.     

Timeline
The development of the monitoring framework is expected to take approximately 30 days starting mid-April  2023. The timeframe is as follow:

• Phase 1: April 18, 2023 to May, 30, 2023
• Phase 2: June 1, 2023 to June 30, 2023.

Mode of Payment

• The consultant will be paid based on an estimate of days worked for each phase, following the completion of the deliverables.

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Background

• The World Health Organization (WHO) describes self-care as ‘the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider”.
• Nigeria was one of the first countries to adapt the WHO Consolidated Guideline on Self-Care Interventions for Health, in support of its goal towards universal health coverage. The National Self-Care Guideline proposes concrete interventions across six thematic areas: demand generation/SBC, service delivery, supply of products, supervision, monitoring and data management, advocacy and financing as well as coordination and regulation. An operational plan also exists to translate the guideline into expected health outcomes along the evidence-policy-implementation continuum.
• To accelerate Nigeria’s self-care agenda, it is important to build on the initial rapid landscape assessment that was part of Nigeria’s national guidelines on self-care for SRMH and identify constraints within the health system that hamper effective and efficient delivery of self-care interventions in the country. In addition, it is important to understand the policy enablers and barriers to sustainable scale-up of self-care interventions and to begin the opportunities and unlock the significant bottlenecks.
• JSI seeks a consultant to identify bottlenecks that hamper accelerated progress of the national SRMH self-care agenda, analyzing their causes and proposing recommendations to inform strategies for scale-up of self-care interventions in Nigeria.
• The main aim of the study would be to aid evidence-based planning to increase effective coverage of self-care interventions by identifying priority bottlenecks to health system performance and local solutions to resolve them.

Additional Objectives Include:

• To identify, inventory and review the WHO guidelines on self-care and all available national policies and guidelines that are relevant to achieving the national self-care agenda.
• To analyze key policies and guidelines with the aim of identifying and documenting opportunities and bottlenecks to the achievement of key implementation objectives outlined in the thematic areas of the National Self-Care Guideline ie demand generation and SBC, service delivery, supply of self-care products, advocacy and financing, coordination and regulation, supervision, monitoring and data management.
• To engage with stakeholders from the Federal Ministry of Health, other relevant Ministries, Departments, Agencies, Donors and Implementing partners to prioritize bottlenecks documented, find solutions and corrective actions to inform strategies for effective scale-up of self-care interventions.
• To develop a comprehensive document that analyzes the main enablers, bottlenecks, causes and solutions to ensure scale up of self-care interventions in the country. 
• The selected consultant will also be responsible for major research activities and analysis write-up: contributing to and submitting the study protocol and tools for local ethical review (if applicable); conducting a landscape assessment (qualitative data collection).

Key Deliverables and Associated Activities

• Inception meeting: A virtual meeting between FMoH, the consultant and Self-Care Accelerator project (JSI) team to further define and finalize the scope and the design of the landscape analysis. Based on this meeting, the consultant will submit a revised (final) proposal.
• Desk review/content analysis: The consultant will conduct desk review of relevant documents to enable better understanding of the scope of the study and synthesize all relevant documentation including the project proposal, logical or result framework, National policies relevant to SRMH self-care, previous related bottleneck assessments, relevant studies conducted by CSOs and NGOs, Implementing Partners’ reports, academic reports, newspaper reports, and other documentation. The information gathered will inform design of the data collection tools.
• Map all relevant stakeholders that will participate in the qualitative aspects of this study. The consultant will facilitate submission of all relevant materials for local ethical approval (if applicable)
• Key informant interviews/Focus Group Discussions: This may involve federal and state ministries of health, donors, implementing partners and other relevant key stakeholders. Specific methodology, tools, respondents, and parameters for these activities to be agreed upon between FMoH, consultant and JSI team. All transcripts to be translated and shared with JSI.
• Conduct a comprehensive analysis of the current resources and investments in self-care for SRMH interventions in Nigeria: self-care partners, timing and level of investment according to thematic areas, sector, level of health system etc
• Using appropriate research software, analyze all identified policies and guidelines to identify enablers and/or bottlenecks to the self-care enabling environment related to:
  • Demand generation/SBC
  • Service delivery
  • Supply of products
  • Supervision, monitored and data management
  • Advocacy and financing
  • Coordination and regulation
• Conduct qualitative/quantitative analysis of available evidence
• Facilitate validation meetings with relevant stakeholders to present findings, prioritize identified bottlenecks, deliberate on the causes of these bottlenecks and document proposed solutions to ensure an enabling environment for scale-up of self-care interventions. 
• Frequently on a weekly basis (or as agreed upon prior), email or Skype updates report the number of outcomes of quantitative inquiry, KIIs and/ FGDs completed during data collection in addition to progress updates, challenges and risks.

Final Report:

• The consultant will produce a report that analyzes and triangulates all information to meet the objectives of the consultancy. The table of contents of the report is to be agreed upon mutually between the consultant and JSI team in advance. Approximate length of report is 20-25 pages, not including annexes.

PowerPoint presentation:

• Approximately 15-20 slides summarizing findings to be presented to the JSI team.

Summary Brief:

• Approximately 2-3 pages summarizing top-level findings, carefully constructed infographics are welcomed.
• Prepare and submit a final manuscript for publication
• Participate in Dissemination meeting
•  Respond to and make further revisions where necessary, based on feedback from peer review.

Other:

• Any other activities as discussed and agreed upon by both parties.

Anticipated Reporting rRequirements and Deliverables to Submit to JSI After Each Relevant Phase is Completed
Phase 1:

• Research Protocol
•  Local IRB submission and approval (if applicable)
• Questionnaires, templates, checklists and other tools relevant to conducting the study.
• Data collection plan.
• Analysis plan.
• The raw and cleaned qualitative data set; verbatim transcripts in English of all FGDs and KIIs
• Sketch of the manuscript

Phase 2:

• Zero draft of the manuscript
• First draft of the manuscript with JSI inputs
• Validation meeting with relevant stakeholders
• The manuscript for journal submission
• Revised manuscript based on peer review
• Final manuscript (which includes all reviewers’ edits) submitted to journal for publication
• A comprehensive report on the bottlenecks that hamper accelerated progress of the national SRMH self-care agenda, their causes and proposed recommendations to inform strategies for scale-up of self-care interventions in Nigeria.
• PowerPoint presentation highlighting enablers and barriers to sustainable scale-up of self-care interventions. 

Required Skills and Experience

• Master’s Degree in a related field (Public Health, Sociology, International Development or Other Social Science) required for the local PI.
•  Significant experience in public health policy formulation and research will be an advantage
• Consultant must demonstrate significant experience (at least 5 years) with both quantitative and qualitative research design, implementation, analysis and reporting.
• Significant facilitation and interviewing skills.
• Significant experience in large-scale surveys.
• Demonstrated experience conducting research on sensitive topic areas related to health, such as sexual health, reproductive health, family planning, etc.
• Have experience in social research methods i.e. interviews with decision-makers, data analysis, etc. 
• Demonstrable understanding of the development and content of national health policy, strategic documents and action plans
• Demonstrable experience working with multiple stakeholders on developing a strategic document
• Proven verbal and written communication skills
• Ability to draw conclusions from multiple data sources and present evidence-based analysis
•  Be fluent in both written and spoken English 
•  Be able to work independently, arranging travel, appointments and interviews for him/herself, as well as ability to work in a team-based environment. 
• Be able to work closely with the government agencies, JSI staff and project partner organizations in Nigeria

Estimate Days of Work:

• The estimated number of days for this consultancy is 30 days spread across the work period below, with possibility of an extension (to a maximum of 5 days) subject to performance by the consultant, and ‘extenuating’ circumstances agreed by JSI that may lead to an extension in the period of assignment.

Timeline:

• The bottleneck analysis is expected to take approximately 30 days starting mid-April 2023.

The timeframe is as follow:

• Phase 1: April 18, 2023 to May, 30, 2023
• Phase 2: June 1, 2023 to June 30, 2023.

Mode of payment

• The consultant will be paid based on an estimate of days worked for each phase, following the completion of the deliverables.