Draft - Terms of Refrerence

Terms of Reference For Assessment of LHWs involvement in Routine EPI in Khyber Pakhtunkhwa Centre for Public Policy Research Institute of Management Sciences Peshawar

1. Background

Improving routine immunization is one of the key indicators for ensuring a reduction in childhood mortality. Pakistan stands an improved chance of achieving the Millennium Development Goals (MDGs) by improving routine immunization through intensified efforts. Unfortunately many children are being needlessly affected by vaccine preventable diseases despite the availability of safe, effective and free vaccines. Improving routine immunization still remains a major challenge in Pakistan. Accessibility to Extended Programme for Immunization (EPI) services irregular outreach activities, increase drop out and some of the major areas hindering efforts towards improving routine EPI coverage

The issues of vaccine procurements, storage, transport, and administration have been empirically proven to affect immunization programs. Knowledge, aptitude, and practices of communities, parents, immunization staff, and LHWs are also important to understand in order to understand ways of improving immunization coverage. While EPI administration can be clearly strengthened, it is the overall health system administration that needs to be understood in contextual settings of health delivery in rural areas of Khyber Pakhtunkhwa.

2. Scope of the Assessment This assessment focuses on a comprehensive investigation of extension of the involvement of LHWs in the 6 target districts and their effective contribution to the implementation of EPI programme in Khyber Pakhtunkhwa. The main indicators of the effectiveness as outlined by the Terms of Reference are as follow:  Assess the knowledge and practices of the LHWs in routine EPI;  Operationalization status of the LHWs, as per given information;  Assess coordination with EPI at facility and district level;  Measure awareness level of the community regarding the routine EPI, as well As LHWs involvement;  Impact of the activity in increasing the coverage of routine EPI;  % reduction in the dropouts etc;  Overall management of the logistic system including vaccines, safety boxes, syringes IEC material;  Reporting mechanism from LHWs to EPI and DPIU;

3. Objective of the study The proposed assessment focuses on a comprehensive investigation of extension of the involvement of LHWs in the target districts and their effective contribution to the implementation of EPI programme in 6 districts of Khyber Pakhtunkhwa. The study will look into the process and management of EPI and LHW program to identify achievements and challenges for the goal of 100% coverage. The study also intends to conduct a KAP survey in the target districts.

4. Purpose, Scope and Coverage of the Consultancy:

The overall purpose of this consultancy is to undertake field work in 6 districts, namely Upper Dir, Lower Dir, Abbotabad, Mansehra, Buner & Swabi. Consulting organization is to identify the field team including both men & women in equal numbers (enumerators, supervisors, field liaison etc.), design and conduct their training and undertake the data collection activities on the basis of agreed deployment plan. Total number of HH questionnaires to be conducted is 850. Consultants will be provided with the methodology and sample design. The survey will be conducted in at least two locations in the district. Female enumerators are required to be present in every team.

5. Reporting & Deliverables

a) Preparatory phase

. Identification of field teams . finalizing the timeline and field deployment plans

b) Field Phase . Close coordination with project team in conduct of the field work . Daily activity report

c) Deliverables . Final field report . Handing over of questionnaires to core team.

6. Timeframe The survey should be completed between December 10- 24, 2012.

7. Required Competencies of the Consultants

o Having expertise of conducting similar exercises in the past, preferably for an international organization. o Previous related experience with IM|Sciences will be an asset.

How to Apply? The organization/ individual will be required to submit a proposal and budget (as separate files) along with organizational profile via email for review and selection to [email protected] by December 2, 2012. Hard copies of the proposals should be sent to Centre for Public Policy Research, Institute of Management Sciences, 1-A, Sector E-5, Phase VII, Hayatabad, Peshawar- Pakistan, in separate sealed envelopes. Late and incomplete proposals will not be entertained.