Consultancy to Determine Factors that Contribute to Defaulting Among Individuals in HIV Treatment Through Qualitative Approaches at Kenya Red Cross Society

• Purpose: The program intends to carry out a qualitative assessment to determine factors that contribute to defaulting among individuals enrolled for HIV treatment, Care and Support among individuals living with HIV, and recommend strategies to strengthen ART retention in the 33 counties of grant implementation. This is a continuous quality improvement approach that will facilitate to identify process gaps and the information would be vital to inform adaptation of strategies in fostering provision of differentiated service deliveries to individual living with HIV to enhance ART retention across the program areas.
• Broad Objective: The general objective of the assessment is to establish reasons for defaulting from HIV treatment, Care and Support among individuals living with HIV to inform ART retention strategies in the 33 counties of implementation.

The specific objectives.
The specific objectives for the review will include, to:

• Determine factors that contribute to defaulting among individuals enrolled for HIV treatment, Care and Support among individuals living with HIV in 33 counties.
• Assess bottle necks in delivering differentiated service delivery model through defaulter identification and linkage back to health facilities for treatment in the 33 counties.
• Recommend retention strategies for adoption that would contribute to high impact in ART retention among individuals living with HIV in 33 counties.

Scope of Work:

• Geographical coverage: The scope is informed by the current program coverage, which includes the following counties: Bungoma, Busia, Elgeyo Marakwet, Garissa, Homa Bay, Isiolo, Kajiado, Kakamega, Kericho, Kiambu, Kisii, Kisumu, Kitui, Kwale, Laikipia, Lamu, Mandera, Marsabit, Meru, Migori, Mombasa, Nairobi, Nakuru, Nandi, Samburu, Siaya, Taita Taveta, Tana River, Trans Nzoia, Turkana, Uasin Gishu, Vihiga and Wajir Counties of Kenya
• Target groups: The assessment will target men and women aged 18 years and above (inclusive of key and vulnerable population) as well as services providers such as community volunteers
• (community adolescent treatment supporters (CATS), peer champions, expert patients) health care workers (HCWs), SCHMT representative and sub recipients (SRs).

Expected Outputs:

• A technical and financial response to the call for applications outlining the understanding of the task, detailing the appropriate methodology for the assessment, work plan and budget.
• Protocol development for submission to Ethics and Scientific Review Committee prior to research exercise.
• A final report of the assessment submitted to the evaluation team, including raw, final databases and any recorded materials.
• Deliverables: The assessment will be phased with deliverables at intervals that will be discussed and agreed with the successful bidder However, at the minimum.
• The Protocol submission and approval by the Ethics and Scientific Review Committee.

Final assessment report.
Evaluation Methodology Approaches

• KRCS recommends for effective approaches and design that responds to the proposed work, requirement and the assessment objectives. However, Evaluation Management Team (EMT) may recommend additional approaches as appropriate.

Quality & Ethical Standards

• The applicant is expected to outline quality and ethical standard in the proposal and ensure that the assessment is designed and conducted to respect and protect the rights and welfare of vulnerable populations. The findings of the assessment will be expected to be technically accurate and reliable; and conducted in a transparent and impartial manner.
• The team will be required to adhere to the research standards and applicable practices as recommended by the Red Cross and Red Crescent Movement, which include: Utility - Assessments must be useful and used; Feasibility - Assessments must be realistic, diplomatic, and managed in a sensible, cost-effective manner; Ethics & Legality - Assessments must be conducted in an ethical and legal manner, with regard for the welfare of those involved in and affected by the assessment; Impartiality & Independence - Assessments should be impartial, providing a comprehensive and unbiased assessment that considers the views of all stakeholders; Transparency - assessment activities should reflect an attitude of openness and transparency; Accuracy - Assessments should be technically accurate, providing sufficient information about the data collection, analysis, and interpretation methods so that its worth or merit can be determined; Participation - Stakeholders should be consulted and meaningfully involved in the assessment process when feasible and appropriate; Collaboration - Collaboration between key operating partners in the assessment process improves the legitimacy and utility of the assessment.
• The assessment is also expected to be conducted in a manner that respects the seven Fundamental Principles of the Red Cross and Red Crescent: 1) humanity, 2) impartiality, 3) neutrality, 4) independence, 5) voluntary service, 6) unity, and 7) universality.

Qualifications and Experience for the evaluation firm
For the purposes of this assignment, a successful organization/company will be required to have the following:

• A registered and experienced in carrying out evaluations or related assignment for at least five years in Kenya.
• The organization/company should demonstrate strong local understanding of Differentiated ART service delivery and HIV care as well as counselling and psycho-social support.
• Previously carried out researches or surveys on treatment, care and support using qualitative approaches.
• Experience in protocol development, handling ethical approvals from approved independent review and ethical board.
• Demonstrate adequate knowledge and skills in qualitative research design, data collection, analysis and reporting.
• Good analytical (qualitative), presentation and writing in English.
• Ready to carry out the assignment and deliver results within a short time.

Management of the Assessment

• Duration: The entire survey will take a maximum of 40 days. The scheduled is between 4th December 2023 to 19th January 2024.

Requirements:

• Protocol for approval by Ethics and Scientific Review Committee.
• A soft copy Draft report, editable for review and inputs.
• Final Assessment report, well visualized and soft copy in a Flash Disk, including the data materials, PowerPoint presentation used during disseminations.
• Dissemination of the report to stakeholders/TWG.

Roles of Evaluation Management Team: The role and responsibilities for the team will include, but not limited to:

• Development and finalization of the assessment Terms of reference.
• Procure the consulting firm and provide the necessary linkage during the process.
• Provide Consulting team with the relevant documents as required.
• Plan for the report validation meeting with key stakeholders.
• Review and approve the assessment documents and the final report.
• Make fund available to the consultant as per the contract document.
• Role of the Consultant: The successful consultant will be required to engage with KRCS team in undertaking its key roles and responsibilities, which include:
• Responding to the TOR, detailing its understanding and local context of HIV treatment, care and support, experiences, methodological approaches (including proposed sample and sampling), work plan and budget.
• Undertaking a desk review and developing and protocol/inception report as per KRCS agreed standard.
• Developing appropriate data collection instruments for the assignment.
• Selecting, sensitizing research team, and overseeing field work, data analysis and report writing
• Submitting a final assessment report.
• Developing dissemination pack and facilitate actual dissemination of the review exercise to key stakeholders.
• Sharing all the data sets with KRCS.