TERMS OF REFERENCE

TERMS OF REFERENCE

Technical Support to Develop Health Policy in HARIPUR Municipality, Sarlahi, MADHESH PRADESH

  1. Background

Rural Women Upliftment Association (RWUA), Haripur Sarlahi is non- governmental, non-profitable and non – political organization registered in District Administrative Office (DAO) Sarlahi district and affiliation with Social Welfare Council SWC in 2050 B.S. (1993 AD) with the goals to social reform in Sarlahi district. Its women leaded notable organization. Since its establishment It has been working with partnership with INGOs and government. It involves integrated development through the social and mobilization of women and disadvantage community people to bring them in mainstream of development. The organization has working experience with more than 20 NGOs, INGO’s, government entities, CBOs. It has highly qualified & skilled human resources for effective and fruitful result in the community.

We work with key child rights stakeholders-including children, communities, civil society organizations, media and government – to enable them to play a stronger role to realize the rights of children. We look for sustainable solutions that will benefit children and their communities by improving education and healthcare systems, and helping communities better prepare and respond to disasters.

Introduction

Nepal in recent years enters into the federal system. The country now has three tiers of government, seven provinces, 77 districts, 753 paalikas and 6743 wards, with paalika being the smallest electoral unit Federalism has created several potential opportunities and challenges for the national healthcare system The decision making has been devolved to the federal, provincial and local governments, and they can make decisions that are more representative of their localized health needs meaning, the local units (paalikas) now have the autonomy to make local laws, acts, policies and strategies remaining within their jurisdictions. They also have the rights to plan programs, activities, manage budgets earmarked for their paalikas and mobilize their local resources as per the local needs.  Some key challenges that could be associated with federalism as seen in the context of other countries such as de prioritization of social sectors like health leading to decline in proportions of budgets, lack of clarity in the delineation of authority within the jurisdiction of the different layers of the government, management of human resources are challenges that Nepal will continue to face for a couple of years.

Madhesh Pradesh state is one of the focus areas of Save the Children. Several projects of Save the children work within the health theme in the state.  Sammunati/ Sponsorship Project is the prime project and works in three districts and work in areas of health, education and supports the local governments in policy and legislation. The project has an agreement with the State and selected paalikas to provide support policy/strategies/guidelines formulation and update and implementation of agreed program. Saving Newborn Lives (SNL) is funded by the Bill and Melinda Gates Foundation (BMGF) and has been working in Nepal since 2000. SNL4 works in Nepal to engage partners and stakeholders to continue its roles as catalyst in areas of newborn health with a focus on reaching high effective coverage of prioritized interventions (namely chlorhexidine and PSBI treatment). It works in partnership with different Ministries/Departments, NGOs, and civil societies to influence policies, programs and implementation related to newborn health.

In 2018, understanding the challenges of the process of federalisation, Save the Children conducted sensitisation workshop in the province; the participants included a team of elected representative, chief executive officer and health coordinators from all of the paalikas  and the orientation was conducted in 8 batched ( one in each district). The objective was to orient the key health stakeholders on the current constitutional and policy environment in health, the roles of each tier of the government and key areas to focus on specially in Maternal and newborn health.  Recently, the local level government have been requesting the organisation for technical support in developing health policy.  Considering the current needs for support in systems strengthening at the level of the local government, Save the children has decided to initiate support in and extend support as per need in selected palikas.  Per policy,  SCI as an INGO does not have the mandate to support direct support to draft  policies, Save has decided to support the palika by recruiting an organisation with  technical expertise in health policy  to provide technical guidance , facilitate consultations with the local government and help them draft a policy for their palika. The aim is to support the paalika to identify their priority health issues, their current challenges and establish a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. The process will be carried out with engagement of local government as they are the sole responsible unit to formulate and endorse the necessary policies, guideline, strategies etc.

  1. Objectives

The key objective of this assignment is:

  • Support Haripur Municipality to develop and endorse health policies at palika level in line with the changed context harmonizing with provincial and federal health policy

 

  1. Methodological Framework

The assignment of this consultancy includes a desk review of existing documents, guideline, protocols, strategies etc related to policy and programs implemented at local level.please include in the methodology as stated in the frame below

Step 7: Draft Policy Preparation

Step 8: Consultation meetings and consensus-building with a wider audience of stakeholders

Step 9: Submission of the final draft to the Local Government.

Step 4: Identifying the issues

4.a. Develop the vision

4.b. Perform Overall SWOT Analysis through FGD/in-depth interview

4.c. Identify Policy topics through FGD/Consultation/In-depth interview

Step 5: Policy Workshop 1

Providing the evidence

5.a. Finalize all SWOT documents

5.b. Identify key elements by grouping or SWOT statements

5.c. Start SWOT statement verification and validation by rumor- opinion-fact analysis

Step 6: policy Workshop 2

Formulating policy statements

Step 1: Establish policy working group in local level

Step 2: Desk review

Collect relevant documents

Step 3: Analysis of Documents

Local level policy working group

–          Mayor/Deputy mayor

–          Chief Administrative Officer

–          Ward Chairs

–          Department Head (According to policy)

–          Representatives of Children

–          Private Sector

–          Political party representative

–          NGOs/INGOs

–          Others (as per LG)

In-depth interviews and focus group discussion shall be conducted with relevant stakeholders to understand the local context, identify gaps and recommended ideas to incorporate in policy. Further, few workshops are required to capture the wider perspectives of different relevant stakeholders.

The consultants will directly coordinate with Project Coordinator of Sponsorship  ( RWUA ) and Field Officers Health and Nutrition  – Health & Nutrition (SAMMUNATI) and Policy Support Coordinator for implementation of desk review. He/she will be responsible for following scope of work:

  • Desk review: The objective is to identify the current health status of the Paalika, the key issues and gaps in the area. The consultant will be responsible to make the list of policy documents, guidelines, protocols, strategies, etc to be reviewed and shared with technical working group for the verification and consensus. Along with this, review of secondary health related information from HMIS, Nepal Demographic Health Survey (NDHS), Annual Health Report and National Health Facility Survey (NHFS). The consultant will also explore the local level policy environment around engagement of private sector in health service delivery.
  • Gap Analysis: The aim of this is to identify the gaps of palika to develop a concrete health policy. Also, while developing health policy we envision to focus on Maternal Newborn Health (MNH), Private Sector and Child rights.
  • Tools development for FGD (is essential) and In-depth Interview (optional): The consultant firm will be responsible to develop tools for conducting FGD and IDI based on the findings of the desk review and first level of stakeholder consultation meeting. This will be done in consultation with SCI
  • Stakeholders Consultation Meeting: The objective of this is to consult with stakeholders in terms of developing a framework to initiate the health policy formulation. This will give a desired outline on the methodology to envision the context of their Palika level health policy. This will be a platform for creating a technical working group from these stakeholders who would provide guidance to the consultants.
  • Focus group discussion: The focus group discussion will be conducted with the homogenous group of FCHVs and Health Mother Groups to identify the root cause of key health issues that have been identified during the desk review and consultation meeting. Further, to know their perspective on how and what to address in the current health policy. There will be at least 8 FGDs.
  • In-depth Interview (optional): The key-in-depth interviews will be carried in order to gather the opinion of key stakeholders (Provincial level MOSD representative, Ward Chair, HFoMC member, Service provider, Health Coordinator, Mayor, Deputy Mayor, Chief Executive Officer) to address current issues on health policy. There will be a representation from most deprived and marginalized from the local paalika. Seven key-in-depth interviews shall be completed.

 

  1. Consultation (Policy Design Workshop) workshops: There will be a workshop with relevant stakeholders. At least 2 days (preferred 3 days workshop) required to draft the content The firm/consultant need to facilitate the workshops at local level. Use different methods like discussion, pp presentation, brainstorming, group work etc to engage the participants and to bring their ideas. Use different tools for active participation of stakeholders during the workshop. Prepare and provide hard/soft copy of tools, relevant documents for stakeholder’s active participation.
  2. 1st Draft Submission
  3. Validation Workshop
  4. Prepare Final draft of Health Policy: In consultation with technical working group, develop a draft health policy and provide necessary technical inputs on policy document submitted as 1st Draft and ensure the policy is in line with Provincial and Federal policy and plan documents. Further, review and submit final draft of health Policy to endorsed by Palika assembly.

 

Role of the consultants

  • Provide overall technical expertise in policy formulation and follow the methodology as stated above in the assignment
  • Facilitate workshops and draft the content
  • Share the draft policy for technical group and address the comments received to prepare the final draft

Role of RWUA

  • Provide an overall technical and managerial oversight and guidance till the completion of the assignment
  • Provide support to consultants in liasing with the local paalika
  • To manage logistics for the workshop or stakeholders’ meetings

 

The consultants will coordinate closely with RWUA/Save the Children  during all the phases of the policy development and will provide technical guidance in all areas with focus on maternal and newborn issues.

 

Deliverables and Timeline

S.N. Activity Deliverables/Outputs Timeline
1. Signing agreement with RWUA Agreement Document Beginning of 2nd week of June 2022
2. Desk review List of documents, guideline, protocols, strategies.

 

Draft report of Desk review

3rd week of June
3. Formation of and guidance to Technical working Groups: Form TWG for policy and draft at each Paalika selected for support. Name list of Technical Working Group 3rd week of June
4. FGD and IDD tools development Submission of tools (hard and soft copy) 3rd week of June
5. Focus Group Discussion Transcription of FGD

Submission of audio recordings

4th week of June
6. In-depth Interviews with relevant stakeholders Transcription of FGD

Submission of audio recordings

4th week of June
7. Conduct policy design workshops

 

Workshop Agenda and report 1st week of July
8. Draft the policy by consultant 2nd week of July
9. Technical Review of 1st Draft:

 

Draft Policy Submission 3rd week of July
10. Submission of Final version of Health Policy

(dissemination workshop )

 

Final Health Policy 31st July  2022

The assignment is expected to start by June 8, 2022 and conclude by July 31, 2022 (With final deliverables Final version of the Health Policy). The Consultant may be an individual or firm.

 

  1. Consultant Specification

The consulting agency should have the following qualifications to effectively carry out the proposed tasks:

  • At least 3 years’ experience in policy formulation and at least one local level health policy formulated in the past. Having experiences on on policy dialogues with GoN at national level, and provincial level will be an added advantage
  • Have experience of conducting training /orientation on local level planning process.
  • Comprehensive understanding on opportunities and challenges brought about state restructuring with focus on health sector.
  • Good communication and facilitation skills
  • The team should consist of a policy expert and a health expert

 

  1. Supervision Arrangements

Consultants/consulting firms will report deliverables to the Project Coordinator of RWUA, Sponsorship, and Project Coordinator (Health and Nutrition) of Save the Children, Sponsorship. The technical components of the brief will be finalized in consultation with the RWUA / SCI.

Budget

  • Detail of costs with a number of days and schedule, to be submitted from a consultant.
  • The budget for this assignment will be as per the procurement policy of the organization and tax will be deducted as per the government policy of Nepal.
  1. Payment Modality

The payment will be made in three installments.

  • 30 % payment upon signing the contract and submission of the inception report and script.
  • 50% after completion of the first draft sharing workshop.
  • 20% after the completion of the assignment/ final work.

Proposal Submission Guideline/Required Documents

 Proposal Submission Deadline:  6 June 2022

 

Required Documents:

Filled out Consultancy Proposal Form (enclosed with this ToR)

Past experiences of working with development agencies in a related field.

For firms: Copies of- Firm registration certificate, VAT registration certificate, and Latest tax clearance certificate. For firms that are tax exempted by the government, a copy of the tax exemption certificate should be submitted.

For firms: Copies of related qualification certificates

 

If an individual is a full-time staff member of another organization, a no-objection/consent letter signed by the organization head must be submitted along with the proposal. This is not applicable to proposals sent through a firm.

 

Interested consulting/ firms are encouraged to submit their above mentioned legal documents, past experience, and consultancy proposal form with enclosed ToR and submission should be submitted via email to [email protected]  to Rural Women Upliftment Association (RWUA), Haripur Municipality-2, Sarlahi within 06 June 2022 by 5:00 PM