Engagement of Consultancy Firm for Strengthening of local-level leadership and governance to enhance ownership and accountability in the delivery of essential health and nutrition services at the community level.

REQUEST FOR EXPRESSION OF INTEREST

(CONSULTANCY FIRM SELECTION)

TERMS OF REFERENCE (ToRs)

Strengthening of local-level leadership and governance to enhance ownership and accountability in the delivery of essential health and nutrition services at the community level.

Ref: LS-MOH-429197-CS-QCBS-LNHSSP-2024 Issue Date: 21-06-2024

• Background

The Ministry of Health is implementing the Lesotho Nutrition and Health System Strengthening Project (LNHSSP) with the support of the World Bank. The main goal of the project is to increase the utilization and quality of key nutrition and health services and improve selected nutrition behaviors known to reduce stunting.

Component 1 of the project focuses on community-based health and nutrition services. Nutrition-specific and nutrition-sensitive interventions targeting women, infants and young children and adolescents are being implemented at the community level. The expected intermediate outcomes include more children being exclusively breastfed, optimal infant and you child feeding and caring practices, increased coverage of vitamin A, iron-folic acid, and multi-micro-nutrient supplementation and increased use of modern contraceptives, as well as other outcomes being monitored under the integration of health services. Integrated health services shall include but not limited to Maternal Child Health, Maternal Child Neonatal and Nutrition. Through the Nutrition and Health Systems Strengthening Project, the MoH aims to contribute to reduced nutrition challenges including stunting and improved health outcomes, especially among lower-income households, through health system reforms that will lead to increased access to health and nutrition services both at the facility and community levels, and stronger governance of health and nutrition.

In order to successfully execute the integration of health services at the community level, local-level leadership, ownership and governance play a pivotal role. Therefore, taking into consideration the critical institutional spheres which include local governance (e.g. chiefs and councilors) as well as community based health (and other sector) structures as being interconnected is fundamental to ensure effectiveness.

The Ministry of Health intends to establish and train Village Health and Nutrition Committees (VHNC) in order to promote and ensure local-level engagement, ownership and accountability for provision of integrated health, nutrition and nutrition-related services at the community level. The VHNC shall serve for five years and shall meet quarterly to monitor progress in implementing their mandate.

The VHNC roles include the following:

• Engage in joint community mobilizations on health- and nutrition-related issues,

• Conduct community dialogues on health- and nutrition-related issues,

• Monitor implementation of the nutritional and early child stimulation interventions at the village level,

• Regularly communicate health and nutrition status of the under 5s, pregnant mothers and women of child bearing age to the District Nutrition Teams (DNTs), ensuring that these vulnerable groups have access to healthcare services and education on healthy eating and disease prevention,

• Collaborating with local healthcare providers and community organizations to provide education, counselling and support to under 5s, adolescents, pregnant women and women of child bearing age,

• Compile the progress reports and submit to the health center level as well DNT,

• Manage the Grievance Redress Mechanism (GRM), compile quarterly reports and share the reports with the DNT.

The VHNC will comprise of the line ministries, including; Ministry of Local Government, Chieftainship, Home Affairs and Police, Ministry of Social Development, Ministry of Education and Training, Ministry of Agriculture Food Security and Nutrition and other civil organizations and/or partners on the ground whose availability is different for each district.

At the village level, these VHNC will be used to serve as oversight committees for the local community, providing monitoring, support and feedback on health and nutrition matters. They will work alongside health, nutrition and education officers as per the composition of these committees to ensure that programs and interventions are implemented effectively and efficiently. The VHNC will also advocate for improved access to healthcare services and resources, and promote healthy behaviors and practices.

• A precise statement of objectives.

The MOH seeks the services of local NGO/Institution to support the Ministry’s efforts to contribute to reduced stunting and other childhood illnesses, improved immunization coverage, addressing determinants of health and nutrition outcomes, especially among lower-income households, facilitating community leadership involvement to promote and ensure engagement, ownership, and accountability for the provision of health and nutrition services at the community level.

• Specific objectives

• To establish VHNC comprising Chiefs, Councilors ,Agricultural Extension Officers, Village Health Workers, Auxiliary Social Workers, Nutritionists (from Ministry of Agriculture Food and Security and Ministry of Health), civil organizations and partners on the ground.

• To develop an operational framework for the VHNC.

• To orient the VHNCs to demand, monitor and promote health, nutrition, and nutrition-related services with the goal of improving health and nutrition outcomes in their areas of “jurisdiction.”

• To train VHNCs on inter-sectoral collaboration, resource mobilization, leadership’ skills, advocacy and networking skills and monitoring and evaluation.

• To mentor and supervise VHNCs.

• Facilitate coordination and linkages with other health and nutrition stakeholders at community level.

• An outline of the tasks to be carried out (scope of the services):

• Sensitize relevant stakeholders including the District Health Management Teams (DHMTs), line ministries, development partners and NGOs on the establishment of VHNC

• Hold leadership dialogues with local level leadership to discuss the importance of health and nutrition services at the community level

• Develop an operational framework for the VHNCs to guide planning, execution, decision making and performance management in their mandate.

• Establish VHNC In all LNHSS Project areas.

• Sensitize Village Health and Nutrition Committees on their Terms of Reference.

• Train VHNCs on inter-sectoral collaboration, resource mobilization, leadership’ skills, advocacy and networking skills and monitoring and evaluation

• Conduct mentorship and supervision of the VHNCs post the trainings.

• Produce quarterly reports to monitor progress on the assignment

• Schedule for completion of tasks:

Implementation of activities will run for a period of 12 months covering 10 districts of the country.

• Data, services and facilities to be provided by the client:

The client will provide the service provider with documents that will assist in executing the assignment. The client will not provide office space for the service provider except for meetings that take place at the premises of the client. Furthermore, the client will not provide transport for the service provider.

• Deliverables,

• Inception report within three weeks of contract detailing how the NGO/Institution will execute the assignment and including, a communication and awareness-raising plan, an evaluation and monitoring plan (including indicators to monitor progress on deliverables), training plans for the VHNCs, supervision and mentorship plans and a sustainability plan (outlining the strategies for ensuring that the VHNC continue to operate effectively and efficiently, even after the NGO/Firm’s involvement).

• An operational framework for the Village Health and Nutrition Committees developed and approved.

• Reports on leadership dialogues with local level leadership

• Detailed report on Village Health and Nutrition Committees revived and established.

• Quarterly reports produced to monitor progress on the assignment.

• Final end-of-assignment report on the task

• Qualifications of the Firm/NGO

• Legal status recognized by the Government of Lesotho

• Extensive experience and track record (7 + years) of engaging and mobilizing local level leaders (including chiefs and councilors) on development issues;

• Have successfully completed delivery of at least two similar nature and complex assignments within the last seven years

• Strong technical, financial and managerial standing with good track record of performance

• Ability to recruit and train local workers to support the execution of the task

• Wide national coverage and network of the specialized agency/NGO would be preferable

• The firm shall have demonstrated knowledge to produce high quality reports.

• NGO/Firm should have systems in place to monitor and evaluate the impact of the capacity building initiatives.

• NGO/Firm should have the capacity to deliver training sessions effectively, using interactive and participatory methods to engage community leadership. A proven track record to meet its deliverables in the assignment.

• Financial and managerial capacity with track record of respectable performance of at least 7 years.

8.Consultant’s qualifications, experience requirements and consultant’s team composition with estimate of key experts input

Key expert #1: team lead

Qualifications

• Master's degree in public health or community health.

Professional certification

• Certifications related to leadership and governance.

Years of experience

• A minimum of 10 years of relevant professional experience in leadership roles, or governance related to health and community work.

• 7 years’ direct experience working in community development, nonprofit organization management, grassroots organizing, experience working for donor funded projects.

Training and faci