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Background of the project:

The IRC started operations in Chad in 2004 to respond to the humanitarian crisis caused by the influx of refugees from Darfur to eastern Chad, with intervention in the Ouré Cas-soni refugee camp. Assistance to Sudanese refugees has now expanded to the manage-ment of the ten camps in the East and one camp in the West with assistance to refugees and local communities in health, nutrition, and water, hygiene, and sanitation. In 2012, to respond to drought and food insecurity, IRC expanded its geographic coverage in the Guéra region. IRC is currently working in three health districts Mongo, Mangalmé and Mel-fi and is providing prevention and treatment of malnutrition to the local population. In May 2016, IRC opened an office in the Lac region to respond to the Boko Haram crisis. IRC implements assistance projects in health, nutrition as well as protection and response to gender-based violence.

IRC Chad is committed in its 2021-2023 Strategic Action Plan, to continue to provide essential humanitarian services in health, nutrition and protection/GBV, while improving the economic well-being and building the resilience of beneficiaries, especially women and girls. IRC Chad will continue to work with and closely support states actors/Ministries for key areas of intervention so that IRC's actions fit into national policies to ensure better ownership of actions taken.

Since 2016, IRC has been one of the actors contributing to the government's efforts to respond to the humanitarian crisis in Lake Chad. Thus, IRC offers multi-sectoral assistance in health, nutrition, GBV prevention/response, monetary assistance and pre-early recovery to refugees, displaced persons, and host populations under funding from various donors (ASDI, BHA, GFFO and ECHO). In the health sector, in order to respond effectively to the problems of difficult access for populations to health structures, particularly during periods of high security tension, and to ensure continuity of care with the aim of reducing infant mortality rates, IRC has introduced in 2019 the community care approach piloted by community health workers: ICCM.

The iCCM approach (Integrated Community Case Management) is a strategy for extending the management of childhood illness beyond health facilities, so that more children have access to life-saving treatment. It involves the early prevention and treatment of the main childhood killers. The iCCM package implemented since 2019 includes treatment of three simple pathologies: diarrhea, malaria and simple respiratory infections, as well as screening and referral for acute malnutrition. A total of 54 sites are operational to date in the Liwa district, thanks to funding from SIDA, SRF, AFD and the support of IRC. These sites have provided treatment for simple pathologies for 1,595 children under the age of 05 from 2019 to the present day (December 2023).

After 04 years of experience in implementing the iCCM approach, IRC is interested in evaluating the implementation process and the added value of this approach in relation to initial expectations. The evaluation will be carried out by an internal and external consultant. These terms of reference describe the modalities and expected results of the evaluation.

Objectives:

This is a mid-term assessment of the operational implementation and results achieved since the start of the implementation of the iCCM approach in Lake Chad. The objective is to provide detailed information and evidence on the implementation of iCCM in order to draw lessons (learning) to improve decision-making on practices, increase accountability, and facilitate potential extension to other IRC areas of intervention.

Specific objectives of the evaluation:

  • Assess the implementation process of the iCCM approach, the state of progress and the resources deployed.
  • Assess the relevance of the package of activities being implemented as part of the iCCM approach.
  • Assess CHWs' understanding and application of the iCCM protocol (screening, compliance with care protocol: admission, discharge, and referral criteria, etc.).
  • Analyze and assess the degree of commitment of stakeholders (community health workers; health center managers; members of the health district management team, beneficiaries, sub-cluster members, etc.).
  • Identify the internal boosts and barriers to IRC, as well as the impact of the ICCM approach on other interventions in the study area or beyond.
  • Identify the strengths and weaknesses of the current iCCM program.
  • Identify opportunities and success factors and formulate recommendations for a highly integrated approach to the management of malnutrition within fixed health structures, mobile clinics, and iCCM.
  • Formulate recommendations for the continuation of the project in line with the criteria of impact, effectiveness, efficiency, sustainability, and empowerment of beneficiaries.

Activities: 

  • Develop assessment tools and materials for subsequent validation by IRC health/nutrition coordinator, IRC MEAL coordinator and IRC HQ,
  • Propose a sampling framework, to be validated by the IRC nutrition coordinator and IRC HQ,
  • Provide all raw and cleaned data sets for data collection to IRC Chad and IRC HQ.
  • Organize and directly supervise data collection,
  • Identify factors affecting service utilization at ICCM community sites in IRC target areas, 
  • In collaboration with IRC program staff, develop specific recommendations to improve program acceptance and coverage,
  • Report on all processes and provide the final evaluation report including recommendations.

Deliverables:

  • For the successful completion of the evaluation, the consultant will provide a methodology and a detailed work plan and provide the deliverables below:
  • An inception report including an evaluation timeline will be provided by February 05, 2024.
  • An evaluation report including clear recommendations for further scaling up of the iCCM approach is prepared by March 15, 2024.
  • Recommendations for the continuation of the project in line with the criteria of impact, effectiveness, efficiency, sustainability, and empowerment of beneficiaries are formulated.
  • Identify gaps toolkit and materials adapted to the context.

Note: All original study instruments with their field data recorded; Copies of all Excel files/databases used for data analysis will be shared with IRC

The health and nutrition Management team ok du Tchad will provide overall monitoring of the consultation.

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Confirmed 18 hours ago. Posted 30+ days ago.

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