HeRon Process Evaluation Consultant

Work Arrangement:

Job Description

Background

After concluding the FCDO-funded Health Resilience in Northeast Nigeria (HeRON) Phase I (April 2020 – May 2022), the program transitioned to a USAID funded cooperative agreement for Phase II (May 2022 – May 2024). The project is being implemented in collaboration with government partners – Borno and Yobe state MoHs. Across both phases, the program seeks to save lives and reduce suffering for the poorest and most vulnerable in North-East Nigeria.

Phase II specifically focuses on rebuilding a resilient health system to ensure people are protected from and treated for the main causes of morbidity and mortality, with particular focus on women, girls, and other marginalized groups. The program collaborates with MoHs in both states to implement a sustainability roadmap through a gradual transition plan. A comprehensive exit strategy has been planned and Transition and Sustainability MoUs have already been signed with the partners. The Transition and Sustainability strategy (TSS) focuses on four transition domains for sustainability:

- Community health influencers, promoters and services (CHIPS) financial support: Gradual wean off & government take over under the 5% Basic Healthcare Provision Fund (BHCPF) allocation - MoH staff incentives - Danger pay (Gradual wean off & government take over at the next Annual Operational Plan Cycle in both states) - Nutrition stabilization centers: Management & operation transition to MoH/Hospital Management Board (HMB) - Procurement of essential drugs and medical supplies for PHCCs (One-off see into State Drug Revolving Fund - DRF)

The TSS is being implemented in four gradual phases:

- Phase 1 (Jun – Nov 22): Engagements, Foundation laying & MoU - Phase 2 (Dec 22 – May 23): Capacity Building/ Training - Phase 3 (Jun – Nov 23): Technical monitoring and advice - Phase 4 (Dec 23 – May 24): Gradual transition to the States’ government systems

A joint task force (MoH & HeRON) has been established to track progress across the transition domains.

Objective of the evaluation

The HeRON comprehensive exit strategy offers an opportunity to capture lessons learned and to generate best practices to ensure the sustainability of partnership-based health system strengthening programs outcomes and processes.

A process evaluation of the implementation of the Transition and Sustainability strategy (TSS) is proposed as a method to determine how effective the transition of program components to partners has been. Specifically, the project will look at topics such as, but not limited to, (1) the coordination and communication with partners, (2) operational and resource management, (3) management practices, and (4) relevance and quality of technical assistance & capacity building activities, including staff capacity to support the transition process, and (5) the government’s willingness/readiness to sustain the health system's supply and demand sides at PHC level, including an identification of challenges or limitations faced by the government to do so, specifically (6) the effects of the 2023 elections and the political transition on the implementation of the TSS. It will examine what worked well and what could have been improved and how. Importantly, it will center on partners’ perspectives and feedback.

Scope and Process

The evaluation will be co-led by the Global Research Consultant and a local Research Consultant, who will be hired for the purpose of the process evaluation delivery. The Global Consultant will develop the research methodology and tools in coordination with the HeRON program team and will secure the IRC IRB approval if necessary. The both consultants will conduct primary data collection and analysis. The local Consultant will be responsible in full for collecting data in the target location (with partners and IRC staff). The Global Consultant will conduct interviews with IRC staff remotely via Zoom or MS Teams or through email exchange. Written interviews might require a second follow-up exchange between the interviewer and the respondent. The two research team members will jointly develop a codebook through a hybrid deductive-inductive analysis approach to analyze the data in Dedoose and the data (program documents and key informant interview transcripts) will be blindly coded individually by both. The two researchers will jointly draft the evaluation report and present the findings to the HeRON program team, including the partners, and the donor. The IRC will also aim at sharing the lessons learned from the HeRON Transition and Sustainability strategy (TSS) with the global health system strengthening community (through participation at the 2024 Health Systems research symposium and/or the Health Systems in FCAS Thematic Working Group, for example).

The evaluation will rely on the review of program documents (secondary data) and qualitative data collection – individual interviews with key informants. These will include IRC program staff and partner staff involved in the program, including all members of the Joint Task Force, Community health workers (CHIPS), staff in Nutrition stabilization centers, the Managers of states’ health schemes (BHCPF, Equity fund), DRF Focal persons, and members of Health Facility Management Committees and Ward Development Committees. During the period of data collection, the Research Consultant will also attend the Joint Task Force meetings and take observational notes. If feasible, the local Consultant might organize thematic group or individual interviews with JTF members after the meeting(s).

The study team will review relevant existing guidelines and frameworks (e.g. the BHCPF scheme), operational documents (MoUs and similar), program reports (quarterly, yearly), and relevant meeting minutes (meetings between IRC and partners, Joint Task Force meetings).

Proposed timeline

- Develop methodology and tools: 2 days - Document review: 3 days - IRB application and revisions: 2 days - Data collection: 15 days - Data analysis: 5 days - Report write up: 5 days - Presentation of findings and report revisions: 3 days

The total number of days is 35. The days are not continuous. The anticipated total duration of the evaluation period is 12 months, from June 2023 to May 2024.

Primary Deliverables to be completed by the Global Consultant:

- Research methodology and tools - IRB ethics application packet - Analysis plan and codebook (with input from the local researcher) - Evaluation report and presentation (with input from the local researcher)

Qualifications

Qualifications (Global consultant):

- Master’s Degree in Social Sciences, Development Studies, Political Science, Public Health, Public Policy or related fields preferred. - Training in research methods and experience conducting qualitative research - Experience working with non-profit organizations and development or humanitarian contexts preferred - Strong project management and organizational skills - Strong communication skills, both written and oral. - Excellent interpersonal skills and ability to work with multicultural teams across different technical sectors. - Fluency in English (written and spoken) is required.