Consultant to Develop RMNCAH, Nutrition and NCD Social Behavior Change Communication (SBCC)

HEALTH SYSTEMS STRENGTHENING FOR HUMAN CAPITAL DEVELOPMENT PROJECT

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REQUEST FOR CURRICULUM VITAE FOR SOCIAL BEHAVIOR CHANGE COMMUNICATION (SBCC) FOR THE MINISTRY OF HEALTH

KINGDOM OF ESWATINI

Reference Number: SZ-MOH-295779-CS-INDV

• Project Background

To meet the National Health Sector Strategic Plan’s (NHSSP 2019-23) policy objective – “build an efficient, equitable, client-centered health system for accelerated attainment of the highest standard of health for all people in Eswatini” – the MOH recognizes the need to invest in health system strengthening to improve the coverage of essential services and the quality of care. Modernizing the foundations of the health system and applying evidence-based improvements are key to achieving better quality care and, through that, reduced child and adult mortality and stunting for human capital formation.

To address key challenges in the health sector, the MOH is implementing the HSS4HCDP to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health and nutrition (RMNCAH-N), and non-communicable disease (NCD) services (hypertension and diabetes) in Eswatini. The project development objective is to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH), nutrition and NCD services (hypertension and diabetes) in Eswatini. The project development objective is to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH), nutrition and NCD services (hypertension and diabetes) in Eswatini. The project development objective is to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH), nutrition and NCD services (hypertension and diabetes) in Eswatini. The project development objective is to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH), nutrition and NCD services (hypertension and diabetes) in Eswatini.The project focuses on strengthening the health system and ramping up investments in RMNCAH-N and NCD services to address critical human capital challenges, including stunting, child and adult mortality, and applying a life course approach. The project includes the following components: Component 1: Improve health service delivery to increase the coverage and quality of health services to build human capital; Component 2. Increase community demand for RMNCAH-N, and NCD services; Component 3. Strengthen the MOH’s stewardship capacity to manage essential health and nutrition services and project activities; and Component 4: Contingent Emergency Response Component.

The project is complementary to the Eswatini COVID-19 Emergency Response Project (ERP: P173883) and is designed to deepen and extend its investment impact through focusing on medium-term structural changes and the modernization of the health sector.

The project is complementary to the Eswatini COVID-19 ERP and is designed to deepen and extend the COVID-19 ERP’s investment impact through focusing on medium-term structural changes and the modernization of the health sector.

• Background to the assignment The persistent high maternal and child mortality, increase in NCDs and malnutrition affect the country’s human capital formation. For Example, despite increased access to antenatal care (ANC, 76% attend at least 4 visits) and women delivering in health facilities (88%), Eswatini’s Maternal Mortality Ratio (MMR) remains very high (437/100,000). Most maternal deaths are linked to poor health seeking behaviour leading to late reporting for quality care. Other factors that affect poor health outcomes include, poor and untimely utilization of health services (e.g., early antenatal care, postnatal care, etc), socio-cultural and traditional beliefs, practices, lack of knowledge and awareness. To help address these challenges, community dialogues and targeted community based SBCC interventions are required.

The MOH uses different platforms to conduct SBCC interventions such as mass media through national radio on weekly basis, and television and print media on an adhoc basis. Additionally, there are SBCC interventions carried out in all health facilities through daily health education sessions. However, the challenge is that majority of these interventions are skewed towards HIV services. Some specialized health facilities, provide SBCC interventions aligned to their mandate, affecting coverage of RMNCAH-N and NCDs SBCC interventions.

At regional level, the MoH has a decentralized Health Promotion Unit which is responsible for planning and implementation of SBCC activities through varied approaches; community dialogues campaign (cultural events in schools and churches), and engagement in corporate spaces. At community level SBCC activities are done by Rural Health Motivators (RHMs), who conduct door to door visits, engage communities, and support groups to promote healthy behaviors by providing key messages essential for awareness generation and interpersonal counselling. However, there are several gaps that inhibit the effective functioning of RHMs some of which include: lack of IEC materials; inability to address socio-cultural norms and challenges faced by the community, poor supportive supervision and feedback on community engagements; and poor coordination of communication interventions across different thematic areas on RMNCAH-N and NCDs.

Improving health outcomes in Eswatini requires a four-pronged approach: improving quality clinical services at health facilities on one hand and on the other, enhancing awareness on critical maternal and child health and nutrition issues, addressing and influencing critical behaviors that will enhance the uptake of services, and enhancing demand of services at community level through innovative strategic tailored approaches. Given that SBCC is critical to improve health behaviors, enhance adoption of key practices essential to improve health outcomes across the continuum of care, the MOH aims at developing an SBCC strategy on RMNCAH-N and NCDs. This strategy which would be implemented using multiple approaches and across various platforms.

In Eswatini there has been significant strides in SBCC in health, though the focus has been on HIV, thus leaving behind NCDs, and RMNCAH-N. Developing an effective and comprehensive SBCC strategy which is evidence based and developed through a consultative process will help to promote and facilitate positive behavioral change and support the requisite social change for improving health outcomes. To develop a comprehensive SBCC strategy, it is imperative to engage a SBCC consultant who will be responsible for strategy design, its dissemination and overseeing its implementation across multiple platforms, using varied approaches and across many departments within the government.

• Overall Objectives With support from the Health Promotion Unit and other technical departments in MOH, and in consultation with the relevant partners, the consultant is expected to achieve three specific objectives:

Specific Objectives

• Lead the design of the SBCC strategy focusing mainly on RMNCAH & N and NCD related technical areas. The strategy should: (a) consider messages for awareness generation; (b) address socio-cultural norms and traditions to promote the uptake of healthy behaviors; and (c) enhance demand for essential services. To develop the strategy, the consultant would need to (i) review secondary literature and collect/compile community level data (i.e., formative research) in order to have an understanding of the key bottlenecks and service delivery challenges and identify possible opportunities within the community to address these; and (ii) using the information gathered and with an understanding of the government’s infrastructure, design and develop a comprehensive SBCC strategy using multiple approaches, targeted at multiple levels i.e., national, sub-national levels including the community and health facility level.
• Support the Health Promotion Unit, Nutrition Council, RHM Program (including trainers and RHMs), NCD Program, and Sexual and Reproductive Health (SRH) Program to implement the SBCC program at national, regional and community level. This would include (a) review of the existing job aids/ tools, training, and all communication materials for all service providers, (b) development of key messages in each of the thematic areas and based on the formative research, and (c) updating / developing new communication tools that addresses common cultural practices and produces positive outcomes on RMNCAH-N and NCDs, e.g., barriers to infant and child feeding.
• Support in the development of a monitoring and evaluation framework for the SBCC activities undertaken. This will include appropriate monitoring indicators, community engagement measurements, and all data related to SBCC implementation and monitoring and evaluation of its impact on the community.

• Qualifications and required skills
• Postgraduate degree or equivalent in Social and Behaviour Change Communication, Public Health or any other related field
• Required experience
• At least 10 years of professional experience implementing health related SBCC programs or advising on SBCC interventions; experience with campaigns related to equity and inclusion preferred.
• Developing and testing of materials, conducting community engagement and social mobilization.
• Use of new and emerging information and communication technologies to reach audiences effectively and at scale
• Designing and conducting formative research and monitoring, evaluation and learning related to SBCC
• Advocacy and networking skills with a broad range of stakeholders including government, private sector, civil society, NGOs and other development partners
• Excellent interpersonal skills, including strong professional co