Final Evaluation
Sustaining access to primary healthcare, mental health and psychosocial support, sexual and reproductive health, including treatment and care for victims of gender-based violence in Northern Uganda – Health response to the impact of the protracted South Sudanese crisis in Uganda
1.Context
MdM is an international solidarity association which has a mission to cure the most vulnerable populations who are living in situations of crisis and exclusion throughout France and the world.
Brief presentation of the project
Bidibidi settlement, Yumbe district, Northern Region was established in September 2016 to host the rapid influx of South Sudanese refugees, primarily arriving from the Equatoria region. The settlement population increased rapidly making Bidibidi one of the largest refugee settlements in the world. As of December 2016, the settlement has swelled covering more than 100 square miles, having reached maximum capacity and stopped accepting new arrivals. In August 2018, the Bidibidi settlement is still one of the largest refugee hosting sites worldwide with approximately 287,541 South Sudanese refugees (latest official figures from the Office of the Prime Minister and the UNHCR). The overall health context and living conditions, while being below emergency threshold, remain fragile due to the profile of the refugees (large proportion of children, women without husband). According to Epicentre, 52.4% of refugees are female and 60% are aged 15 and below.
This project was developed following a fact-finding mission that initially took place in Bidibidi refugee settlement, Yumbe district, from the 4th until the 12th of July 2017. The fact-finding mission focused more particularly on : areas served by health facilities supported by MSF, especially the Bolomoni Health Centre level 3 (HC III), an analysis of mental health, psychosocial support and gender-based violence (GBV) and their mechanisms in place, their integration into broader primary health care and reproduction health services, and how to improve them.
As part of its strategy, MSF had planned to stop its support to the Bolomoni Health Centre. In July 2018, after several months of discussions, MdM took over from MSF the outpatient department (OPD) of Bolomoni HC III, with MSF still in charge of the inpatient department (IPD). MdM finally took over the IPD in January 2019.
Bolomoni health centre III (OPD and IPD) was built by MSF in 2016, in the peak of South Sudanese’s refugee influx. The structure is semi-permanent with concrete floor, wood structure and roofing in metal. It is a modern facility meeting the WHO standards on facility infrastructure, qualified staff, drugs, supplies and equipment, wash and waste management, use of partograph, referral system. It is located on the border between Bidibidi and Imvepi settlements, which makes it a strategic location. The catchment population is estimated to 65,000 refugees and 15,000 people from host communities. With out-patient (OPD) and in-patient (IPD) managed by MdM and MSF respectively, Bolomoni provides South Sudanese refugees from zone 4A of Bidibidi settlement (31% of the total number of consultations in June 2018) and host local population (30% of consultations). At the time of the project proposal development there was also a growing number of refugees from zone 1 of Imvepi settlement attending the hospital for secondary care (34% of consultations).
In order to support the activities at Bolomoni hospital, a project proposal was developed and presented to the DGD, through MdM-Belgium. The DGD approved the funding starting 1st December 2018 (until 31st March 2020).
As part of the project proposal, the following objectives and results had to be reached:
-Principal objective: To contribute to the reduction of morbidity and mortality among South Sudanese refugees in Bidibidi settlement and their host communities in Yumbe district, Northern Uganda.
-Specific objective: To sustain access to primary healthcare (PHC), mental health and psychosocial support (MHPSS), sexual and reproductive health (SRH), including treatment and care for victims of gender-based violence (GBV), for South Sudanese refugees in Bidibidi and surrounding Refugee settlement and their host communities in Yumbe district, northern Uganda.
Results:
R1 : The delivery of the Minimum Initial Services Package (MISP) for sexual and reproductive health for refugees and host communities is consolidated and it evolves in the delivery of comprehensive SRH services.
R2 : Quality mental health and psychosocial services (MHPSS) for refugee and host communities are reinforced.
R3 : Surveillance and response to communicable diseases and treatment of main diseases are strengthened.
R4 : The feasibility conditions for better access to justice for GBV survivors are supported at the local and national levels.
The most important challenges and issues faced during the project implementation are the following:
-Staff turnover and gaps in human resources, especially in key coordination positions
-Sustainability: it was planned to hand over the Bolomoni health centre to the Ugandan authorities, if the structure was made permanent. However, MdM could not secure funding to build a permanent structure, MdM could not either secure funding to the continuation of services provision. Therefore, it is currently searching for another partner to take over the centre
-Increased services demand beyond target population, due to:
- MHPSS support provided to the patients
- Ambulance to move patients from community to the centre
- Food for patients offered in In-Patient Department (IPD)
- Availability of Mental Health specialist and drugs
- Gaps in services in the surrounding structures
-Procurements and medicines and consumables availability
-COVID-19: mitigations measures had to be implemented
2.Objectives of the consultancy
MdM, in the framework of this project, is looking for (a) consultant(s) to assess the effectiveness of the project design and achievements of its expected results and objectives. Final recommendations from this evaluation might feed future interventions in similar contexts.
This evaluation has two main objectives:
- Accountability towards the beneficiaries, partners and the donor
- Learning: contribute to MdM’s expertise in the direct delivery of sexual and reproductive health services, gender-based violence, mental health and psychosocial services in a post-emergency context
The criteria to be covered by this evaluation are the following: relevance, effectiveness, sustainability/connectedness, coverage and equity, efficiency and impact.
The evaluation will take place at the Bolomoni hospital, in the Bidibidi refugee site in the Yumbe District in Uganda. MdM-France has an office in Yumbe, which is about 22 kilometres from the Bidibidi refugee site. The period covered by the evaluation will be from the 1st December 2018 until 31st March 2020. The entirety of the project needs to be evaluated in line with the above-mentioned criteria.
The maximum total budget available for this consultancy is 20,000 euros.
3.Sought after profile
We require the following from the candidate research consultancy firms or individual consultants:
- Prior experience in evaluation mandatory (please provide references and example of previous evaluation assignments);
- Experience and expertise in Sexual and Reproductive Health/GBV/MHPSS mandatory;
- Experience in health facility management an asset;
- Knowledge of refugee sites context in Uganda;
- Knowledge of South Sudanese context is an asset;
- Knowledge of the Lugbara language is an asset;
- Strong analytical skills and ability to clearly synthesize and present findings draw practical conclusions, make recommendations and to prepare well-written reports in a timely manner.
National Ugandans are strongly encouraged to apply. Females are strongly encouraged to postulate too.
4.Schedule
Application deadline : August 31, 2020 at 6:00 PM (CET)
Deadline for a complete proposal : September 18, 2020 at 5:00 PM (CET)
Required start date for the assessment : October 1, 2020
‘Field’ phase of the consultancy : 21 days, between October 7 and October 31, 2020
Required date for the hand-over of the definitive report : November 16, 2020
This schedule is indicative and can be submitted for modifications.
5.Documents to be submitted
The consultants and/or research consultancy firms who wish to apply to this call for expression of interest, must transmit:
- A CV (maximum 3 pages)
- A cover letter (maximum 3 pages) indicating: experience in similar conditions, references regarding the execution of analogue contracts, dates when available to consult, other, etc…
These applications must be sent to the following email address:
[email protected] with as the reference subject: ‘UGANDA / BIDIBIDI Evaluation before August 31, 2020 at 6:00 PM (Paris time/CET).
A maximum of six candidates will be short-listed and invited to submit a complete proposal replying to the terms of reference which will be sent to them.
How to apply
Applications must be sent to the following email address: [email protected] with as the reference subject: ‘UGANDA / BIDIBIDI Evaluation before August 31, 2020 at 6:00 PM (Paris time/CET).
More Information
- Job City Uganda
