REPUBLIC OF KENYA MINISTRY OF WATER AND IRRIGATION. Kenya Water Security and Climate Resilience Project -2

Transcription

1 REPUBLIC OF KENYA MINISTRY OF WATER AND IRRIGATION Kenya Water Security and Climate Resilience Project -2 (Coast Region Water Security and Climate Resilience Project) Project No.: P Credit No. IDA 5543-KE TERMS OF REFERENCE FOR CONSULTANCY SERVICES FOR ESTABLISHMENT OF COMMUNITY HEALTH UNITS IN KWALE COUNTY MARCH P a g e

2 Table of Contents LIST OF ABBREVIATIONS INTRODUCTION AND CONTEXT General overview Project Institutional and Implementation Arrangements Project Implementation and Role of PMU Kwale County Project Implementation Unit (PIU) DESCRIPTION OF THE PROJECT AREA General area description Economic activities KWALE COUNTY GENERAL SANITATION OVERVIEW OBJECTIVES SCOPE AND OUTCOMES OF THE SERVICES Objectives Scope of the Consultancy services Expected Outcomes Consultants staff qualifications??project REPORTING REQUIREMENTS Assignment duration and deliverables Reporting schedule MANAGEMENT AND LOGISTICAL SUPPORT P a g e

3 LIST OF ABBREVIATIONS CBO ODF CU CHV CLTS GOK IDA KWSCRP MOWI NGO PIU PMU PS TOR Community Based Organisation Open Defecation Free Community health units Community Health Volunteer Community Led Total Sanitation Government of Kenya International Development Agency Kenya Water Security and Climate Resilience Project Ministry Of Water and Irrigation Non-Governmental Organization Project Implementation Unit Project Management Unit Principle Secretary Terms of Reference 3 P a g e

4 1 INTRODUCTION AND CONTEXT General overview The government has planned a large-scale water investment program to close the massive water infrastructure gap that has been estimated at US$5 7 billion. This is to be supported by the establishment of a strong and modern institutional and legal structure that aligns the water sector with the Constitution of Kenya Towards this end, the Ministry of Water and Irrigation (MoWI) is undertaking an ambitious agenda for the water sector through a long-term, transformational program aimed at building water security and climate resilience for economic growth and social well-being. The Kenya Water Security and Climate Resilience Program (KWSCRP) responds to this need. The overarching development objective of the program is to improve water security and build climate resilience in Kenya. The first phase of the program, KWSCRP-1 was approved by the World Bank board on June 18, 2013 and declared effective on October 24, The project development objectives of KWSCRP-1 are to: (i) increase availability and productivity of irrigation water for project beneficiaries; and (ii) enhance the institutional framework and strengthen capacity for water security and climate resilience for the country. KWSCRP-1 focuses on the progressive development of a water investment pipeline, integrated and participatory basin planning, and technical assistance to the evolving water sector institutions and sector reforms at a critical period of constitutional and political transition. The Coastal Region Water Security and Climate Resilience Project (KWSCRP-2) is the second operation under the program and its design is consistent with the approach envisaged for the program in that investment preparation follows a sound investment framework and incorporates a multi-sectoral, multi-dimensional approach. The project will improve access to water and sanitation, general health conditions and quality of life among poor urban and rural households that currently rely on expensive water sources and are exposed to serious health risks due to lack of sanitation. It will also contribute to Kenya s Vision 2030, MTP 2 and sectoral plans for water and sanitation to ensure that improved water and sanitation are available and accessible to all. These activities are being developed and aligned with Kwale and Mombasa County Integrated Development Plans (CIDPs). Mwache Dam and related infrastructure would in particular act as a buffer against the most severe hydrologic shocks (including floods and droughts), as well as address food insecurity, low productivity, and constrained growth in Mombasa County and throughout the coastal region more broadly. The project has three main components supporting the project development objective: (i) Component 1-Mwache Dam and Related Investments; and (ii) Component 2-Kwale County Development Support. In addition, Component 3 - Project Management will support project implementation. Component 1: Mwache Dam and Related Infrastructure (US$165 million) Sub-Component 1.1: Civil Works and Related Infrastructure (US$160 million) 4 P a g e

5 This comprises the development of Mwache Dam, which is ultimately expected to provide 186,000 m3/day (67.9 MCM/year) for urban water supply to Mombasa County and Kwale County. An additional potential supply of 41,000 m3/day (about 15 MCM/year), with lower reliability of 75 percent vis-à-vis an urban water supply reliability of 99 percent, will be available from the dam. Sub-Component 1.2: Mwache Catchment Management (US$5 million) This sub-component aims to improve sustainability of the Mwache catchment, integrating conservation activities with the needs of local communities to develop sustainable economic activities. Recognizing that a robust watershed management strategy entails addressing ecosystem degradation at the watershed level, this sub-component supports an integrated, participative approach to water resources management, introducing sustainable livestock, agriculture, forestry and land management practices, and integrating conservation activities with the needs of local communities to develop sustainable economic activities. Activities under the sub-component will be based on livelihoods, to ensure that communities will have incentives to play an active and engaged role in conservation activities. Component 2: Kwale County Development Support (US$25 million) The Kwale County Development Support (KCDS) component supports development in Kwale County, where the Mwache Dam is located. The following is an outline of the sub-components under KCDS. Sub-Component 2.1: Water Supply Investments (US$12 million) This sub-component will support increased access to water supply in small towns and rural communities in Kwale County based on the priority for Kwale County through rehabilitation and expansion of existing water supply schemes in urban areas. In terms of rural supply, priority will be given to communities affected by the construction of the dam while rural water investments will be informed by the Kwale Water Resources Assessment and Water Supply Development Master Plan that will be prepared under KWSCRP-1. Sub-Component 2.2: Sanitation Investments (US$4 million) This sub-component will support increased access to improved sanitation facilities in both urban and rural areas, with priority being given to the later. On the policy side, the project will support the development of a strategy to promote household sanitation, taking into account cultural beliefs and training on sanitation and hygiene. Specifically, and in line with the Kenya Ministry of Health s approach and guidelines, the sub-component will support Kwale County in strengthening the programmatic conditions to implement Community-Led Total Sanitation (CLTS) and sanitation marketing at scale, while strengthening supply and household demand for improved sanitation. 5 P a g e

6 Sub-Component 2.3: Sustainable Livelihoods Improvement (US$5.5 million) This sub-component seeks to improve livelihoods in Kwale County, considered as the wider area of influence of the Mwache Dam through support to benefit-sharing and sustainable livelihood paradigms for the largely rural communities in the area. The Sustainable Livelihoods subcomponent in the KCDS seeks to improve livelihoods in Kwale County, considered as the wider area of influence of the Mwache Dam through support to benefit-sharing and sustainable livelihood paradigms for the largely rural communities in the area. Focus will be where required. Catchment conservation practices are not sustainable per se, such as in steep slope and river bank crop cultivation, where alternative livelihoods need to be supported. In these areas, the component will aim to develop alternative livelihood activities for common interest groups currently dependent on the unsustainable use of natural resources, focusing on new income-generating activities. This component will adopt a demand-driven approach, whereby proposals will be sought from communities in the catchments and forest perimeters to invest in livelihood-enhancing microprojects that support the natural resource base. These could include opportunities to establish afforestation schemes; the development of private sector/community partnerships for timber, fuelwood and/or fodder production; the production/sale of seedlings; the introduction of productivityenhancing techniques of agro-forestry or conservation farming, beekeeping, and other investments in farm agriculture development will be supported. Proposals will be vetted and shortlisted for support by the Livelihoods Steering Committee (LSC). Sub-Component 2.4: Irrigation Demonstration Scheme (US$3.5 million) This sub-component will support the final preparation and implementation of an irrigation demonstration scheme on an area of about 100 ha. The demonstration project will also establish the viability of developing a larger (between 2,000 and 3,000 ha) irrigation scheme in the area. 1.1 Project Institutional and Implementation Arrangements Project Implementation and Role of PMU Ministry of Water and Irrigation (MOWI) will serve as the implementing agency of the project through the established Project Management Unit (PMU). The PMU, which reports to the MOWI Principal Secretary (PS), has been granted a high degree of autonomy to ensure efficient and timely implementation of the project. The PS, as the Accounting Officer of the Ministry, has delegated procurement and financial management responsibilities to the PMU, within the Legal Framework stipulated in the procurement laws of Kenya. The core functions of the PMU are coordination and facilitation; fiduciary (procurement and financial management), environmental and social safeguards supervision, monitoring and evaluation (M&E) and impact evaluation (IE), annual work programming and budgeting, and reporting Kwale County Project Implementation Unit (PIU). The execution of the Sanitation component of the project shall be done through a PIU established by Kwale County. The PIU comprises of Kwale County staff and is responsible for the day-to-day 6 P a g e

7 operations of the project. The PIU shall work closely with the consultant and together with the PMU shall be responsible for joint review of all reports submitted by the Consultant, inspection and progress monitoring through regular meetings and approval of payments as detailed in the consultancy contract. The PIU shall also assist in stakeholder coordination, organizing consultative meetings and the implementation activities agreed with the consultant and in line with the CLTS framework. 2 DESCRIPTION OF THE PROJECT AREA General area description Kwale County is located in the southeastern coast region of Kenya. The County stretches from the Kinango Sub-County in the northwest to the Indian Ocean coast in the east (see Figure 1). The County covers an area of about 8,270 km 2. The County has four major topographic features, coastal plain, coastal uplands (the Shimba hills), the Nyika plateau and flat plateau in the hinterland. The County has a bi-modal rainfall pattern with annual rainfall ranging from 600 mm in the hinterland to 1400mm along the coastline and temperatures range from 20 0 to P a g e

8 Figure 1: Kwale County location The County comprises of three administrative sub-counties namely Matuga, Kinango and Msambweni and Lunga Lunga and had a population estimated at 649,951 as per 2009 national population census, the County thus has a population density estimated at 79/km 2. The rural areas cover more than 95% of the County. About 80% of the County population lives in the rural areas. Kwale County urban areas comprise of five small towns, namely; Kwale, Kinango, Ukunda, Msambweni and Lunga Lunga. The total urban population was estimated in the 2009 national population census at 137,863 people Economic activities Kwale County has a poverty index level of percent, compared with the national average of 45 percent. Kwale is therefore one of the very poor counties in the country. Majority of the county population, who are in the rural areas mainly keep livestock as their source of livelihood. Subsistence farming is also practiced. The main crops grown in the area include maize, sorghum, cow peas, cassava and sweet potatoes. The agricultural productivity is very low mainly due to a combination of adverse climate, poor systems for climate change monitoring and ill-adaptation of the farming practices to these factors. There are five urban areas in Kwale County; Kwale, Kinango, Ukunda, Msambweni and Lungalunga. The urban areas are previous district headquarters and the main sources of livelihood in these areas are formal employment in the public offices and small scale retail trading, mainly in groceries. Ukunda town stretches to the Indian Ocean coast and is an important market for both local and international tourism. Ukunda therefore has modern medium and high-class hotels several shopping malls; a medium sized hospital and several banks are located in the town. Shimba hills game reserve is also an important tourist attraction in the County. Kwale town is the headquarters for Kwale County Government and has high potential for rapid growth as a County Headquarters. There are also two main industries, which provide important economic activities in the County, Base Titanium Company, which is a titanium mining company and Kwale International Sugar Company. 3 KWALE COUNTY GENERAL SANITATION OVERVIEW Kwale County is predominantly rural are. The Kwale County has five small towns, namely Kwale, Ukunda, Msambweni, Kinago and Lunga Lunga, which account for about 18% of the total county population of 649,531 (2009 census). About 15% of the total county population have access to improved water, 18.4% have access to improved sanitation and 51% practice open defecation (compared to the national average of 15%). Out of 464 primary schools and 74 Secondary schools, only 163 (35%) and 42 (57%) are reported to have adequate sanitation, respectively. Kwale County has no piped sewer system and the population relies on septic tanks (especially in urban areas), pit latrines and largely open defecation in the rural areas. 8 P a g e

9 Kwale County Health Sector Strategic and Investment Plan recognizes the major risk factors of morbidity and mortality in the county as; lack of community awareness, negative cultural practices, malnutrition, inadequate access to safe water, inadequate integrated vector control, parasitic infections among others. The effects of poor sanitation are wide ranging. It is important that a multi-sectoral approach is taken to sanitation. Poor sanitation directly affects child health, long-term growth, and susceptibility to chronic disease later in life through severe malnutrition. The non-health benefits of improved sanitation include savings from reductions in time spent walking to place of defecation and waiting for shared latrines, increased school attendance, fewer workplace absences, poverty reduction, and water quality improvements. Raising awareness to address socio-cultural issues surrounding sanitation will protect the surface water reservoirs and reduce the incidence of soil helminthes and other WASH related diseases in Kwale County. Lack of safe water and sanitation along with inadequate hygiene are largely responsible for the leading killers of children under five: diarrheal diseases, pneumonia, neonatal disorders, and under nutrition. Lack of clean water and sanitation brings about nearly 18,000 child deaths a year from diarrhea in Kenya. The Ministry of Health, having adopted the Kenya Essential Package for Health (KEPH) which recognized the community as a critical level of health service delivery, initiated in 2006 the Community Health Strategy (CHS) to scale up the implementation of services and to fast-track the establishment of Community Health Units (CUs) so as to bring services closer to the community, by empowering communities with health information and essential services. According to the Community Strategy Implementation Guidelines for Managers (2007), the overall goal of the CHS is to enhance community access to health care in order to improve productivity and thus reduce poverty, hunger, and child and maternal deaths, as well as improve education performance across all the stages of the life cycle. The objective of the CHS is to improve the health status of Kenyan communities through the initiation and implementation of life-cycle focused health actions at level one by: Providing level one services for all cohorts and socioeconomic groups, including the differently-abled, taking into account their needs and priorities. Building the capacity of the Community Health Extension Workers (CHEWs) and Community-Owned Resource Persons (CORPs) to provide services at level one. Strengthening health facility community linkages through effective decentralization and partnership for the implementation of level one services. Strengthening the community to progressively realize their rights for accessible and quality care and to seek accountability from facility-based health services. Ministry of Health subsequently developed a cadre of staff at community level known as Community Health Volunteers (CHVs). The community health volunteers are the main workforce of community health units. For sanitation, the role of CHVs is to visit allocated households to ensure behavior change from open defecation and continuous improvement of sanitation infrastructure at the household level. 9 P a g e

10 All communities/villages are supposed to implement the Community Health Strategy (CHS) under the guidance of counties. The CHS intends to improve the health status of Kenyan communities through the initiation and implementation of life-cycle focused health actions at village level. One of the objectives of the CHS in tier one 1 of health service provision, is to organize communities into maximum local population clusters of 5,000 people (1,000 House Holds) - a Community Health Unit (CHU) - and empower them to take charge of the collective health status. The CHU is the link and at the same time the catalyst for health seeking behavior between the communities and nearby health facilities. Under the direction and the consultation of the PMU/ Kwale PIU KWSCRP 2.2 Sanitation subcomponent, the consultant will be responsible for developing a detailed work plan for implementing and coordinating all the stages of the establishment and maintenance of CHUs for the sustainability of the Hygiene and Sanitation Component in Kinango, Msambweni, Lunga Lunga and Matuga sub counties in Kwale County. 4 OBJECTIVES SCOPE AND OUTCOMES OF THE SERVICES 4.1 Objectives The objective of the consultancy services under this TOR is to establish and support the CHUs to influence community hygiene and sanitation behavior change so as achieve and sustain Open Defecation Free (ODF) status in target catchments in Kwale County. 4.2 Scope of the Consultancy services Specifically, and in line with the Ministry of Health s approach and guidelines, the Consultant shall support Kwale County in strengthening the programmatic implementation of Community- Led Total Sanitation (CLTS) while strengthening supply and household demand for improved sanitation. The specific scope of work under this assignment include: 1. Establish and support 20 CHUs in Kwale County over twelve months period (June 2016 to May 2017); 2. Train all the CHVs and facilitate all their activities in CLTS in order to maintain the established CHUs; 3. Achieve the target ODF status in the 20 CHUs within the twelve months period, which shall be subject to verification by the County Public health office and/or third party agency; and 4. Create demand for household construction of latrines, dish racks and leaky tins within the catchment area of the CHUs. 1 Tier one is the community level tier of health professionals, the Community Health Extension Workers and the Public Health Officers. 10 P a g e

11 4.3 Expected Outcomes community health units established and supported for one year with ODF at the target catchment; 2. Delivery of sanitation and hygiene CLTS outcomes in community health units as per the MOH CLTS road map and county strategic plan; Community Health Volunteers (20 CHUs) sensitized on CLTS tools and processes; 4. Attain ODF within the target catchment areas; 5. Demand construction for household latrines, dish racks and hand washing facilities by communities within the catchment area; 6. Support community follow up for Sanitation facilities improvement towards higher levels of the sanitation in the sanitation ladder at the villages; 7. Continuous delivery of health and sanitation improvement messages at households by CHVs as per MOH community health strategy guidelines; and CHVs trained on household water, handling, treatment and storage methods. 5 Consultants staff qualifications The required qualifications and indicative responsibilities of the key professional staff are provided in the table below. Designation Main responsibilities Minimum academic qualification/overall experience required Team Leader Overall supervision and Degree in a Public Health or Community guidance to project Development field with minimum 10 years implementation, quality control of inputs and outputs into the project, link person with PIU experience in senior leadership positions including strategic, financial and administrative management. Familiarity with the National and County health systems. Previous hands on experience with CHS and CLTS in Kenya and good knowledge of its approaches and policies, MOH guidelines and county policies of establishment and support of Community Health Units. Hands on experience will be given preference to academic qualification. 11 P a g e

12 Trainer Training, and update of Community Health Volunteers and Community Health Committees Degree in Public Health / Environmental Health. In-depth knowledge of CHS as a high impact intervention in health care and development, and experience in rural hygiene and sanitation options and CLTS approach. Practical hands - on experience in CHS and CLTS training, capacity building and coaching. Field Supervisor Preparation of field rota, organization of field team; community mobilization, support and follow up. Degree in sociology, public health, community development or other relevant field. Prior hands-on experience with management of field work and community mobilization, and support especially on livelihood development. Public health/ community health practical community health and rural sanitation field hands - on experience will be an added advantage. Monitoring Documentation Officer & Responsible for ensuring that all events and activities are documented reported and shared in the agreed format and time frame Degree economics, public health, sociology or relevant degree with experience in monitoring & evaluation, and data analysis In-depth knowledge and experience with the MOH health information system (DHIS). 6 PROJECT REPORTING REQUIREMENTS 6.1 Assignment duration and deliverables The assignment will be for a period of 12-Calendar Months. In undertaking this assignment, the Consultant will be expected to deliver the following; i) Inception report providing the preliminary findings and updated work plans and approach; ii) Baseline survey for sanitation coverage, CLTS and CHS status for the target areas; iii) CHVs training and sensitization reports; iv) Monthly and quarterly progress reports; and v) Project completion report; 12 P a g e

13 6.2 Reporting schedule The schedule of deliverables for this assignment is as shown in table below: Table Reporting schedule S/No. Deliverable Number of copies Date due 1. Inception report 6 4-weeks after Contract commencement 2. Baseline survey report for sanitation coverage, CLTS and CHS status for 6 3-months after Contract commencement the target areas 3. Training and sensitization reports 6 2-weeks after each training and sensitization meetings 4. Monthly progress report 6 2-week after end of every month 5. Assignment completion report 6 4-weeks after assignment completion 7 MANAGEMENT AND LOGISTICAL SUPPORT The consulting firm is expected to have or arrange for all the logistical, which include all staff costs, office and transport costs required to carry out the assignment. 13 P a g e