TERMS OF REFERENCE (TOR) PARTNERSHIP ON HEALTH AND MOBILITY IN EAST AND SOUTHERN AFRICA (PHAMESA), 2014-2017 End-of-Programme Evaluation Title: PHAMESA II End-of-Programme Evaluation Programme Period: 2014-2017 Duration of Evaluation Exercise: 3 months 1. Background Information Established in 1951, IOM is the leading inter-governmental organization in the field of migration and works closely with governmental, intergovernmental and non-governmental partners. With 166 member states, a further eight states holding observer status and offices in over 100 countries, IOM is dedicated to promoting humane and orderly migration for the benefit of all. It does so by providing services and advice to governments and migrants. The organization works with governments and other stakeholder to help ensure the orderly and humane management of migration, to promote international cooperation on migration issues, to assist in the search for practical solutions to migration problems and to provide humanitarian assistance to migrants in need, including refugees and internally displaced people. Together with its partners in the international community, IOM acts to assist in meeting the growing operational challenges of migration governance and to advance understanding of migration issues. IOM aims at encouraging migration-inclusive social and economic development, and to uphold the human dignity and well-being of migrants at every phase of the migration cycle. One of the areas of focus for IOM is migration and health; this addresses the health needs of individual migrants as well as the public health needs of their transit and host communities by assisting governmental and non-governmental partners in the development and implementation of relevant policies and programmes. Through forging and nurturing partnerships with key stakeholders, IOM advocates for the improvement of access and use of services that improve the health of migrants, and communities affected by migration. 2. Partnership on Health and Mobility in East and Southern Africa II (PHAMESA) Programme The World Health Organization (WHO) defines health as a state of physical, mental and social wellbeing and not merely the absence of disease or infirmity (WHO, 1994). Subsequently for IOM, migration health translates to the physical, mental, and social well-being of migrants and host communities affected by migration. Through its Partnership on Health and Mobility in East and Southern Africa (PHAMESA) programme, IOM aims to contribute to the reduced health vulnerability of people affected by the migration process in East and Southern Africa.
Since 2003, IOM has implemented this regional programme with primary support from The Swedish International Development Cooperation Agency (SIDA). In 2014, IOM was awarded a four-year funding to implement the second phase of the PHAMESA programme (PHAMESA II). This was a follow-up of prior successful implementation of the Partnership on HIV and Mobility in Southern Africa (PHAMSA I & II 2003-2009) and the PHAMESA I (2010-2013) programme. Implementation of the health programmes has grown in scope from a focus on HIV in Southern Africa only in PHAMSA, to health more broadly including sexual and reproductive health and rights (SRHR). In terms of geographical reach the PHAMESA programme is implemented in East and Southern Africa. The current PHAMESA II is implemented in Botswana, Kenya, Lesotho, Mauritius (Indian Ocean Commission -IOC), Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda and Zambia. The programme s interventions respond to the World Health Assembly (WHA) Resolution no. 61.17 operational framework on the Right to Health for Migrants (2008). The WHA Resolution 61.17 calls upon Member States to promote migration-sensitive health policies and practices to ensure equitable access to health promotion and care for migrants; establish health information systems in order to assess and analyse trends in migrants health; and devise mechanisms for improving the health for all, including migrant populations. The operational framework agreed upon between IOM, WHO and the government of Spain at a global consultation in Madrid in 2008 outlines four pillars of the WHA (2008) as follows: The PHAMESA programme is built upon these four pillars of the WHA Resolution 61.17. Through the PHAMESA II programme, IOM responds to the public health needs of migrants and communities affected by migrations in collaboration with member states in the two regions. The programme aims to contribute to the reduced health vulnerability of people affected by migration in East and Southern Africa. This is through advocating for the development and implementation of evidencebased policies and programmes that support equitable and sustainable access to services that improve health for all including vulnerable migrants as well as communities affected by migration processes. Below is an over view of the programme s result areas. Diagram I. PHAMESA II programme results-based management framework 2 P a g e
To achieve the above stated results, PHAMESA implements a comprehensive package of interventions that address not only direct health needs, but also the social determinants of health at the individual, institutional, and structural/normative levels. The interventions include: health promotion in communities, service delivery facilitation, capacity building at all levels, advocacy, research, awareness raising and coordination. These interventions target migrants and migrationaffected communities, policy makers, civil servants, healthcare workers, service providers, development partners, civil society organisations, and academia. IOM PHAMESA utilizes various approaches such as the rights based, social determinants of health and the spaces of vulnerability (SoV); the SoV targets geographical areas where migrants and communities interact and can lead to increased health vulnerability. Considering that migration challenges are regional, PHAMESA takes a regional approach to health programming in order to address region-wide factors that impact the health of migrants and migration-affected communities at any point of the migration processes. 3. Purpose of Evaluation & Key Evaluation Questions (KEQ) 3.1 Purpose of Evaluation The IOM in collaboration with SIDA have commissioned an end of programme evaluation to: assess and document the overall difference the PHAMESA programme has made (at individual, community and institutional levels), the effectiveness of the PHAMESA programme against set outcomes; lessons that can be learned to inform future programming; and examine the sustainability of programme benefits. 3 P a g e
It is further expected that the evaluation findings will provide a basis for future programming in response to the changing migration trends and needs. The PHAMESA programme has been in existence for 14 years during which the programme has evolved and grown into what it is today, PHAMESA II. 3.2 Key Evaluation Questions The initial key evaluation questions (KEQ) are: a) What is the impact both positive and negative, intended and unintended of the PHAMESA programme at the individual, community and institutional levels? To document this, the evaluation findings should capture what PHAMESA has achieved in relation to set outcomes, demonstrate what has worked well, what has not worked well; and the external and internal contextual factors that contributed to programme achievements. b) How sound was the programme design and underlying theory in responding to the identified needs and to what extent did this affect programme outcomes? c) Was the utilization of resources human, financial, material and time proportional to outcomes realised? Could implementation have been done more cost effectively and in what aspects of the programme? d) How effective was PHAMESA in mobilizing resources around migration and health through seed funding? What are the lessons can be learned? e) To what extent has sustainability been built into the programme and what aspects of the programme outcomes will be sustainable beyond December 2017 when the programme ends? Bearing in mind that the programme has been going on since 2003 if the evaluation will be able to shed light on what previous achievements have continued to be sustainable and what are the key enablers of the sustainability. f) What are the current existing opportunities in migration and health that can inform IOM s future project/programme development? Linked to this, which PHAMESA s key components require continued interventions? g) How suitable and effective were the approaches used by PHAMESA, were the lessons learnt over time documented and used to improve programme approaches? To what extent does PHAMESA provide a learning space to inform innovation and evidence-based approaches? To respond to this question it is expected that this outcome evaluation will be informed by other formative evaluations such as the 2016 mid-term assessment. The evaluation team selected will be expected to develop further specific questions during the inception stage. In developing the specific evaluation questions, it is expected that the evaluators will take into consideration the Economic Co-operation and Development's (OECD)/Development Assistance Committee (DAC) criteria of efficiency, effectiveness, relevance, impact and sustainability as well as cross cutting programmatic institutional issues. It is expected that the evaluation will also be able to identify how gender equality has been mainstreamed in the programme design and implementation. The following guiding questions are divided into two sections: 1) Standard 4 P a g e
evaluation element questions; and 2) Cross-cutting programmatic and institutional evaluation questions. It is expected that both areas will feature prominently in the evaluation. Standard Evaluation Element Questions Efficiency Were resources used appropriately and economically to produce the desired results? Was the programme accountable and transparent in the use of resources? Effectiveness Did the programme achieve what it had set out to? Which programme components were effective/non effective in bringing about programme achievements? What results did PHAMESA s seed funding approach yield? Relevance Did the programme align with the changing migration dynamics? Are the outcomes beneficial to key stakeholders? Impact What individual, environmental and structural effects has the programme brought to individuals, communities, and institutions either in the short-, medium- or long-term? Are results intended/unintended; positive/negative? Sustainability Are programme activities/interventions likely to continue post December 2017 Have implementing partners, IOM country offices and other key stakeholders developed the capacity and motivation to continue activities/interventions? 4. Evaluation Methodology It is expected that the interested evaluation teams develop a sound methodology in response to the purpose of the evaluation and the stated evaluation questions. During the inception phase, the evaluation team in collaboration with the PHAMESA management team will agree on the KEQ and the evaluation methodology guided by this terms of reference prior to commencement of the evaluation field work. The primary data collection methods may involve key informant interviews, focus group discussions with programme beneficiaries, as well as secondary analysis of relevant documents such as baseline and M&E reports, newsletters and others. In addition to this, literature review of other documents relevant to other IOM s work within the East and Southern Africa region may also be undertaken in 5 P a g e
the efforts to map the project effects. Apart from the stated evaluation methodology, interested evaluators are encouraged to be innovative in proposing an evaluation design that will address the objectives of the evaluation. 5. Evaluation Scope and Responsibilities of the Evaluation Team 5.1 Evaluation Scope: While the evaluation will focus on all PHAMESA II (2014 to 2017) outcomes, the evaluators will need to be cognisant of the fact that the programme has been implemented since 2003 and therefore reference to PHAMESA s previous phases will be important for attribution of results reported in the evaluation. To respond to the evaluation purpose and questions, the evaluation team will need to undertake a systematic review of existing evaluation reports such as the 2016 MTR report and data from the previous phases of the programme. The evaluation will focus on all PHAMESA implementing countries (Botswana, Kenya, Lesotho, Mauritius (IOC), Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda and Zambia) though primary data will be collected in four selected PHAMESA II implementing countries: Kenya, South Africa, Uganda and Zambia. The evaluation will also take into consideration programme limitations and implementation conditions in each of the PHAMESA implementing countries and the influence these have had on the success of the programme. 5.2 Duties and Responsibilities a) Constitute a multi-disciplinary team (as enumerated in the key competencies section) to form the consultancy team; b) Design the evaluation including a sound evaluation methodology in consultation with IOM; c) Produce an inception report comprising of a detailed evaluation protocol with a clear work plan for carrying out the assignment and data collection instruments aligned to the programme s result framework; d) Recruit and train researchers and enumerators on the data collection instruments and study procedures to ensure standardization; e) Conduct a desk review (at all regional and country levels) of any relevant reports, studies, and any other material that could potentially inform the evaluation, including baseline and other programme reports and related documentations; f) Undertake primary data collection at regional, country and community level in selected PHAMESA countries; g) Analyse and synthesize the data using appropriate quantitative and qualitative data analysis tools; 6 P a g e
h) Compile a concise analytical draft evaluation report that adequately responds to the evaluation purpose and questions; i) Organize a preliminary meeting to brief Sida and the IOM management team on the findings; j) Update IOM on a regular basis (weekly) on the progress of the assignment; and k) Incorporate IOM s feedback/comments and prepare a well written analytical evaluation final report; and l) Submit a final report to IOM s management which will have incorporated IOM s input and the evaluation raw data. The Evaluation Team will be managed by the IOM Migration Health Monitoring and Evaluation unit in Pretoria. This will include providing the evaluation team with the necessary documents for desk/document review, facilitating access to stakeholders and partners for interviews, as well as providing assistance on all logistical arrangements. In terms of the organization of the evaluation exercise, the Evaluation Team will be managed by the IOM PHAMESA Monitoring and Evaluation team. A technical reference group headed by the PHAMESA M&E Officer will be set up to guide the evaluation exercise and provide technical over sight. The evaluation reference group will constitute representatives from IOM and SIDA. The M&E Officer will make periodic contact with the evaluation team to review progress and address any emerging challenges during the evaluation exercise. PHAMESA Programme Management will be responsible for providing the evaluation team with the necessary documents for the desk/document review, availing themselves for meetings and interviews, facilitating access to stakeholders and partners, as well as all logistical arrangements. 6. Desired Competencies of the Evaluation Team IOM is looking for a service provider with a strong and good track record in conducting evaluations of complex health programmes. The lead consultant must have sound professional experience, qualifications and skills matching the standards required by this assignment particularly in the field of international health development and excellent theoretical and practical knowledge of monitoring and evaluation. 6.1 Competencies The core skills required for this consultancy will include; a. Demonstrated understanding of Monitoring and Evaluation in health development sector; b. Programme design or programme management particularly related to regional or multi-country programming; c. Public health background; d. Strong background in research methods (including policy research) and report writing, with relevant experience in conducting multi-country/regional research in the East and Southern Africa region; e. Ability to do cost-benefit analysis; 7 P a g e
f. Quantitative and qualitative data analysis skills and proficiency in statistical software packages such as STATA, SPSS, and Nvivo; g. Demonstrated understanding of the link between mobility and health; and h. Excellent knowledge of English (knowledge of Swahili, Portuguese will be an added advantage. 6.2 Experience a) A minimum of 5 years experience in undertaking theory based outcome and impact evaluations in an African context (East and Southern Africa) as well as regional or multicountry programmes; b) Proven record of producing high quality and credible evaluations of health programmes particularly HIV/AIDs and TB (a sample will be required); c) Demonstrated experience and skills in SRHR and HIV/AIDS and TB projects/programmes in East and Southern Africa Demonstrated experience in gender mainstreaming and analysis of gender equality in evaluations in order to identify how gender aspects have been included in the programme interventions; and d) Ability to work within tight timelines and ability to adhere to the originally agreed on evaluation protocol. The Lead evaluator must have a minimum of Master s degree from a recognized university in any of the following disciplines social sciences, public health, health economics, development studies, research; or in related fields. Formal training and proven experience in monitoring and evaluation will be an added advantage. 7. Deliverables The Evaluation Team will submit the following deliverables to IOM Migration Health unit: a) An inception report will be submitted by the team at the start of the consultancy for discussion and agreement. The inception report will include: i. A statement of the evaluators understanding of the TOR; ii. A detailed methodology outlining how the evaluation will be conducted; iii. Data collection tools; and iv. A detailed work plan of how the Final Evaluation will be conducted. b) A Power point presentation of the major findings and areas of recommendations will be made to IOM by the evaluation team before the draft report is written. This will enable early inputs to the evaluation report by IOM. c) A draft report will be submitted to IOM for comments to be considered and incorporated into the final report. The final report of no more than 35 pages including an executive summary (without annexes) will be submitted and will include analyses, findings, lessons, conclusions and recommendations emerging from the review. This final report will also outline key challenges and emerging opportunities for IOM. 8 P a g e
d) Submission of a publishable final evaluation report. The report must be analytical and written in clear language, easy to follow by non-specialists including programme stakeholders and funders and should not exceed 35 pages, excluding relevant annexes and files such as: - Soft copies of qualitative data files, including photos and audio recordings as applicable - Soft copies of raw cleaned quantitative datasets and data analysis syntax in STATA or SPSS format (these files with raw data should be submitted separately). e) The report should be structured as follows 1 : i. Executive summary of key findings and recommendations. (Maximum 4 pages). ii. Introduction/background/context to PHAMESA a. Evaluation purpose and scope b. Evaluation methodology iii. Evaluation findings iv. Lessons learnt v. Recommendations (capturing identified opportunities) vi. Conclusion vii. Annexes It is expected that the evaluation field work will be completed within three months after signing the service agreement with IOM. The final evaluation report should be submitted by August 2017. 8. Fees and Budget Interested service providers are expected to submit an all-inclusive detailed itemized budget as part of their proposal clearly stipulating the consultancy fee applicable. The budget should provide sufficient details, including field visit to Kenya, South Africa, Uganda and Zambia to collect primary data. Payment schedule will be in tranches upon the approval of IOM s satisfaction of the deliverables outlined above. 9. Application Process IOM invites hard copies of proposals from consulting firms, evaluation teams with the required mix of experience and skills. The proposals should include the following: 1. A cover letter introducing the evaluator(s) and describing their mix of skills, experience and competencies that meet the criteria highlighted above. 2. A 10 page (maximum) technical proposal outlining the evaluation process including sufficient details on the methods and approach to the assignment. 3. An itemised price proposal with sufficient details including unit costs and daily rates. 1 The suggested report structure is presented as a guide highlighting the minimum headings expected. It is acknowledged that additions may need to be made in order to reflect evaluation findings. 9 P a g e
4. CV of each team member and, in case it is an organization, a brief profile of the organization. 5. A sample of the most recent similar evaluation. Interested evaluation experts should submit hard copies of their technical and price proposals to: the Attention of Joseph Musyambiri, The International Organization for Migration (IOM), 353 Sanlam Building, Festival Street, Pretoria no later than 14 th April 2017. Late and incomplete proposals will not be considered. 10 P a g e