TERMS OF REFERENCE (TOR) FOR THE ENDLINE SURVEY on the Maternal and Mental Health Access and Psychosocial and Livelihood support to improve Social wel

Organization description

Johanniter-Unfall-Hilfe e.V. (Johanniter International Assistance) is a German non-governmental organisation, dedicated to excellence in the field of first aid, ambulance service, social service programmes and other projects in the medical and social field. The Federal Headquarters are based in Berlin, Germany. Johanniter International Assistance is the department for development co-operation and emergency aid, implementing and supporting projects worldwide. Our aim is to ensure the survival of people affected by disasters and to strengthen and secure the health, resilience and livelihoods of communities in the regions where we work. We develop our international programmes together with local communities in a culturally and gender-sensitive way, based on the community’s needs. We recognize the importance of addressing climate change challenges and gender equality, and include them as core topics in all programmes.

Johanniter has been present in Uganda since 2017 working with national partners and has implemented projects in the areas of health, nutrition, food security and livelihoods and WASH in Adjumani, Palorinya, Rhino Camp and Palabek refugee settlements in hosting districts of Adjumani, Obongi, Madi Okolo and Lamwo respectively.

Transcultural Psychosocial Organisation (TPO) Uganda is a Non-Governmental Organization that started its work in Uganda as Institute for Psychosocial and Social Ecological Research (I.P.S.E.R) in 1994 with a study commissioned by UNHCR on the mental health and psychosocial issues affecting South Sudanese. Upon identification of significant MHPSS issues and needs, UNHCR supported TPO to implement the study recommendations. This gave birth to the TPO programs in Uganda. Later, TPO expanded its MHPSS programming in other countries including Somalia, South Sudan, Congo and Liberia. Over the years, TPO gradually moved its interventions to underserved national communities that were also in need of support. Over the years, TPO Uganda’s programme has expanded to cover mental health and psychosocial support, social protection interventions, child and adolescent focused programs as well as economic empowerment programs for women and vulnerable households.

TPO Uganda is currently present in 45 districts of Uganda, spread across seven sub-regions of Acholi, Lango, Teso, Karamoja sub-region, South West, West Nile and Central Uganda.

Programme Background

Johanniter-Unfall Hilfe (Johanniter International Assistance – Johanniter) has been implementing projects in 4 settlements in Uganda namely Adjumani, Palabek, Palorinya and Rhino Camp with the partners, Community Empowerment for Rural Development (CEFORD) and Agency for Cooperation and Research in Development (ACORD)-Uganda targeting teenage and young mothers, women of reproductive age, and other vulnerable women, including women living with disabilities, with a target of 3,700 direct project participants and 500 male partners as indirect participants, given the role of men in household decision-making. In partnership with CEFORD, Johanniter has been supporting nutrition activities, MHPSS including gender-based violence identification and referrals in three zones in Rhino Camp. In addition, Johanniter has established a complementary field office in Arua, the nearest city to Rhino Camp settlement.

Johanniter has entered into partnership with the Transcultural Psychosocial Organization (TPO), a national organization with over 30 years’ experience in providing holistic services to families and communities affected by conflict, HIV and AIDS, poverty and natural disasters around the thematic areas of mental health and psychosocial support; child care and protection; HIV/AIDS Care and Support, GBV prevention and mitigation, disaster risk reduction and livelihood support through integrated and community participative approaches that enable families and communities to regain their agency, get empowered and become self-reliant. TPO has presence in Rhino Camp and is the UNHCR’s community MHPSS implementing partner. Additionally, TPO Uganda is an active member of the inter-agency working committee, the MHPSS Working Group and the livelihood working group.

Johanniter and TPO Uganda will implement the Maternal and Mental Health Access and Psychosocial and Livelihood support to improve Social well- being (MAMA PLUS) project funded by Aktion Deutschland Hilft (ADH) to increase access to maternal and mental health and psychosocial support services and livelihood support to teenage and young mothers, women of reproductive age, women living with disabilities and other vulnerable women and female survivors of Gender Based Violence. The project will ensure that women access not only maternal and new-born services, but provide support their social-well-being through mental health and livelihood support that improve their coping mechanisms and address their daily stressors thus ensuring a healthy mother and a healthy baby.

Expected Project Results

Result 1.0: Increased access to and utilization of quality maternal-child health care services.

Result 2.0: Enhanced mental and psychosocial well-being of mothers.

Result 3.0: Improved project management.

Purpose of the end-line Survey

The main purpose of the end-line is to examine the context in which the project was implemented and establish end-line values on all project indicators accordingly. The evaluation will include review of the project design and assumptions made at the beginning of the project development process. it will assess the extent to which the project results have been achieved, partnerships established, capacities enhanced, system changes, and cross cutting issues including gender mainstreaming, building resilience among others.

The evaluation will also assess whether the project implementation strategy has been optimum and recommend areas for improvement and learning that will be used to inform future programming.

The evaluation seeks to collect data (quantitatively and qualitatively) on the main elements of the project (access to and utilization of quality maternal-child health care services, mental and psychosocial support services and livelihood assistance) which will be analysed with the base-line data. The survey will collect data from the refugees and members of the host community as our target groups. The evaluation will be guided by the Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) standard evaluation criteria

Scope/ area & population of the End-line Survey

The end-line survey will cover 3 project results and 3 thematic areas namely; maternal-child health care, mental and psychosocial support and economic empowerment components. The geographic scope of the end-line surveys will be in Rhino Camp (Olujobo II and Ocea II Health Centres in Rhino Camp settlement). A purposive sampling technique will be used to target pregnant women and those attending antenatal care and women of reproductive age from the above targeted communities and health facilities.

The end-line survey will also help establish the end-line values of the indicators listed in the table below.

Expected results

Indicators

R1: Increased access to and utilization of quality maternal-child health care services.

• Proportion of mothers reporting improved overall well-being.
• Percentage of mothers attending 8 antenatal care visits.
• Reduction in perinatal mortality rate.
• Percentage of skilled birth attendance.
• Percentage of women who report that they received safe, accessible, accountable, participatory, and safe maternity and child health services.

R. 2: Enhanced mental and psychosocial well-being of mothers.

• Percentage of mothers who received mental health support and showed improvement in their psychological symptoms as per their post assessment scores.
• Percentage of mothers reporting positive coping mechanisms.
• Percentage of women reporting engagement in livelihood activities.
• Number of mothers experiencing perinatal deaths supported with MHPSS
• Number of staffs trained on Cognitive Behavioural Therapy (CBT).
• Number of women supported on Problem (PM+).
• Number of Psychoeducation-Awareness sessions conducted.
• Number of women receiving PFA.
• Number of women trained on Livelihood.
• Number of mothers supported with cash assistance.
• Number of groups supported with cash assistance.

R. 3: Improved project management.

• Number of leaders sensitized disaggregated by age and gender.
• Number of awareness sessions on Safeguarding, PSEAH and the Code of conduct held.
• Number of focus Group Discussions held.
• Number of dialogues conducted.
• Number of quarterly review meetings held.
• Number of community members disaggregated by age and gender attending community dialogues.

Methodology: The consultant will employ a mixed-methods approach, combining qualitative and quantitative methods. This may include document reviews, interviews with potential project participants and stakeholders, on-site inspections, and data analysis.

1. Key Evaluation Questions: The consultant should address the following key questions:

DAC criteria

1.Relevance:

• To what extent was the project’s objectives aligned with the maternal-child health care, mental and psychosocial support and livelihood needs of the of the vulnerable population in the refugee settlement and surrounding communities?
• How culturally appropriate and contextually relevant were the project strategies, especially for marginalized groups such as teenage mothers and women with disabilities?
• To what extent did the project design incorporate the needs and priorities identified by the target communities themselves?

  2. Effectiveness:

• To what extent did the project achieve its intended results across the three thematic areas:
• Increased access to and utilization of maternal-child health services?
• Enhanced mental and psychosocial well-being of mothers?
• Improved access to livelihood support?
• What factors facilitated or hindered the achievement of these intended outcomes?
• To what extent did women and mothers report satisfaction with the services received (ANC visits, MHPSS sessions, livelihood support)?

  3.Efficiency:

• How efficiently were the project resources (financial, human and material) used to deliver the planned activities and outputs?
• Were project activities implemented on time and within budget?
• What cost-effective practices or approaches, if any, contributed to better resource utilization

  4.Impact:

• To what extent did the project outputs contribute directly to the achievement of outcomes if implemented as planned?
• What notable/measurable changes occurred in maternal-child health care services, mental and psychosocial support services and livelihood assistance among the target population as a result of the project?
• How did the project contribute to broader social, economic, or environmental impacts in the project area?
• Were there any unintended positive or negative effects of the project interventions?

  5.Sustainability

• To what extent will the project positive changes outcomes likely to continue beyond the end of the project?
• What local capacities were built to ensure the continued delivery of maternal, MHPSS, and livelihood?
• What are key risks to sustainability, and how can they be mitigated?

  6.Coherence:

• How did the project align and coordinate with the interventions of local government, UNHCR, and other NGOs working in the same areas?
• Were there any conflicting interventions or duplications of efforts within the project area by other organizations?
• To what extent was there internal coherence between different components of the project (e.g., maternal health, MHPSS, and livelihood support) and among project partners (Johanniter and TPO)

Evaluation Outputs/Deliverables

The consultant is expected to produce and submit the following deliverables:

• An inception report detailing a study methodology, implementation plan and data collection tools approved to be approved by Johanniter International Assistance and TPO**: to be submitted within one week upon signing the contract.**
• Refined evaluation questions: Upon review of the available documents and an initial discussion, the evaluator will develop a detailed analytical framework of questions and sub-questions, based on the evaluation questions defined in this ToR, and consistent with Results-Based monitoring framework.
• A final Endline project evaluation report to be approved by Johanniter International Assistance: incorporating feedback and recommendations. The main evaluation report should be concise and not exceed 30 pages, excluding annexes (supporting data and details can be included in annexes).
• A clean data set and transcriptions shared by the consultant
• A Power-Point presentation with the preliminary findings and recommendations to be presented to Johanniter and key stakeholder group.
• Final report printed on art paper with high resolution photos and quality design (hard copy)

Composition of the evaluation team

The consulting firm/team should identify the team leader, and the other key team members. The Team Leader shall provide CVs and a description of each team members’ roles and responsibilities and their corresponding qualifications, such as highest level of education attained, discipline of study, the number of years of relevant experience, language and skills, etc. A team leader with multi discipline background, expertise and skills shall be an added advantage.

Reporting and Supervisory Arrangement

The consulting team will be directly supervised by the Project Officer from Johanniter International Assistance and TPO Uganda. The Project Officer will also furnish the Consultant(s) with all the information required to undertake and complete the assignment.

Required competences and experience

The ideal consultant or consulting firm must consist of a lead consultant who:

• The consulting team/lead consultant must have at least five years’ experience in qualitative and quantitative research/evaluation.
• The consulting team must have experience in Maternal health, SRHR, Mental health, GBV, Women protection interventions, child rights and community engagement and planning experience.
• Have excellent knowledge in qualitative and quantitative data analysis using Microsoft Excel, Minitab, SPSS, CSPRO, STATA and other statistical software.
• Experience in mobile data collection and conversant with mobile data collection such as, Survey ODK, Kobo collect, etc.
• Fluency in English (spoken and written).
• Ability to produce high quality work (info-graphics) and high standard, well-structured reports under tight timeframes.
• Ability to work with children and least educated people.
• Ability to produce well-written reports, in a plain text, demonstrating excellent analytical and communication skills.

Submission of proposal:

Interested Consultants can submit a letter of expression of interest, together with a technical proposal to undertake the evaluation. The technical proposal MUST include the consultant’s understanding of the assignment, CVs of technical staff to undertake the assignment and a detail evaluation cost.

Time frame for the Assignment

The evaluation will be carried out between 30th June to 31st July 2025. The schedule is as follows:

Est. # of Days ; 3 days

Description

This must define the scope of the work with a proposed work plan and evaluation questionnaires/tools to be submitted 3 days following the official commencement of the evaluation. The inception report will provide Johanniter, TPO, and other key stakeholders the opportunity to ascertain that the evaluator(s) share the same understanding about the evaluation objectives. The inception report should detail the evaluators’ understanding of what is being evaluated and why, showing how each evaluation question will be answered by way of: proposed methods; proposed sources of data; and data collection tools and procedures. The inception report should include a proposed schedule of tasks, activities and deliverables, designating a team member with the lead responsibility for each task or product. Before accepted to become the guide for the evaluation, the inception report must be discussed and agreed with the Johanniter Team Member.

Est. # of Days ; 1 day

Inception Report feedback amendment: The consultant will utilize 1 day to amend the corrections given the feedback from the team.

Est. # of Days ; 2 days

Travel days to and from Arua

Est. # of Days ;1 day

Fieldwork Preparation: Recruitment, training and deployment of enumerators, testing of tools and final validation

Est. # of Days ;4 days

Data collection: Deployment of enumerators and data collection including daily post field work debriefing

Est. # of Days ;4 days

Data Analysis: Lead Consultant and team analyze collected data and if need be allowed for review, questioning and field follow up and cross validation of collected data before writing draft report.

Est. # of Days ;4 days

Draft report: The evaluator(s) will have 4 days to write the draft report and then share it for review and comments by all parties involved after analysis of the field data. The draft evaluation report must ensure that the evaluation meets the required quality criteria.

Est. # of Days ;2 days

Final Report: This will be submitted within 2 days after receiving comments on the draft report from Johanniter and TPO. The content and structure of the final analytical report with findings, recommendations and lessons learnt covering the scope of the evaluation should meet the agreed requirements, and must include the following:

• Executive summary (1-2 pages),
• Introduction (1 page),
• Description of the evaluation methodology (6 pages),
• Situational analysis with regard to the outcome, outputs, and partnership strategy (6-7 pages),
• Analysis of opportunities to provide guidance for future programming (3-4 pages),
• Key findings, including best practices and lessons learned (4-5 pages),
• Conclusions and recommendations (4-5 pages).

Appendices: Charts, terms of reference, field visits, people interviewed, documents reviewed

21 days: Total estimated time for deliverables.