Consultancy Jobs at Equity Group Foundation

Introduction

Despite its national economic mobility, Kenya has an overwhelmingly young, poor, and rural population, which faces various disparities in demographic determinants of health. Kenya ranks 147 out of 187 countries on the UN’s Human Development Indicators’ Health Index, placing it in the lowest category of human development (2013), with the government spending just 2.1% of GDP on health. Levels of public expenditure are insufficient to link the general population of over 44 million people (World Bank, 2013) to quality preventive and curative care and to counter Kenya’s disease burden, including HIV/AIDS.

Private healthcare facilities fill some of the access gap, but large facilities are expensive while small facilities provide fragmented care, are often poorly managed, and have limited access to finance needed to scale. Meanwhile the lack of comprehensive and affordable health insurance schemes limits the uptake of private health insurance. Without health insurance, Kenyans are unprepared for when illness and disease strike, and negative economic consequences follow, including missed work, loss of income, depleted savings, loan defaults, hasty borrowing, and suspended financial plans.

Equity Afia is a sustainable, integrated health model that will train and monitor a network of clinician entrepreneurs to provide standardized, quality healthcare throughout the country. Equity Afia will also design and introduce innovative health insurance schemes that are tailored to providers’ behaviors and the health demands and purchasing power of consumers, as a key means to achieve the healthcare system’s long-term financial sustainability and solvency.

It is against this background that the health pillar seeks to engage the services of suitably qualified consultant / firm to undertake a baseline survey using triangulation approach which will primarily constitute detailed document review of data that has already been generated; such as KDHS, KAIS and other secondary data against key program indicators. The intention is to provide baseline values for outcome level indicators for the program as well as provide contextual data against which to compare program performance.

Program Approach

The overall goal of this five-year project is to increase the health status of Kenyans by increasing access to and utilization of quality healthcare and affordable, private health insurance. Equity Afia’s objectives include: 1) provide affordable, high-quality, preventative and primary health services across Kenya; 2) increase health literacy and favorable attitudes about health insurance among Kenyans; and 3) increase the uptake of comprehensive and affordable private health insurance. Key activities include: identify and provide training and technical support to a network of health entrepreneurs; assist health entrepreneurs in accessing financing to launch/improve health facilities using a high volume/low margin (HV/LM) hub and spoke model; lead outreach programs to increase the public’s knowledge of and attitude toward health insurance and overall health literacy; develop and launch health savings accounts, mobile phone applications, and social marketing activities to support outreach; perform data collection and analysis to inform insurance scheme design; engage private sector insurers to underwrite new schemes; and support health facilities in adopting capitation and bundled care payment models.

Against this background, the program primarily aims to ensure sustained improvement of health and well-being for Kenyans by increasing access to and utilization of quality and standardized healthcare and affordable, comprehensive private health insurance. Specifically, the program will aim to achieve the following objectives:

· Objective 1: Improved standardized, affordable, high quality, health care services using a high volume, low margin model

· Objective 2: Increased favorable health and health insurance attitudes, beliefs and literacy among Kenyans

· Objective 3: Increased uptake of affordable and comprehensive health insurance by at least 1,800,000 Kenyans

Theory of Change

Equity Afia believes that if it can increase overall access to standardized and affordable quality healthcare through a scalable private sector-led model, and if this model can yield comprehensive, affordable, and desirable health insurance products that are coupled with initiatives to increase understanding of health and health insurance, Kenyans will opt to direct their financial resources toward the purchase and use of these products and will increasingly place their trust in and access preventive and curative care for themselves and their families, leading to sustained and improved health.

Equity Afia’s theory of change, goal and objectives will be evaluated through three intermediate results:

· Intermediate Result 1(IR1) - Increased access of quality health services, products and information

· Intermediate Result 2(IR2) - Enhanced delivery channels for sustainable delivery of quality health services

· Intermediate Result 3(IR3) - Improved ability of Kenyans to withstand health risks and shocks

These intermediate results will be achieved using three phases through which a main activity for each phase has been developed. The first three years of the project will focus on phases one and two while the last two years will focus on phase three.

Phase 1- Health Care Services Delivery

· Main Activity - Equity Afia will support the establishment of 300 outpatient health franchises across Kenya and execute social marketing campaigns to create demand for their services.

Phase 2- Health Systems Strengthening

Main Activity - Equity Afia will help deploy innovative solutions that can increase efficiency, effectiveness and quality of health service provision in the 300 outpatient health franchises

Phase 3- Health Systems Financing

Main Activity - Equity Afia will offer comprehensive and affordable health financing solutions, including health insurance, to supplement the increased access and utilization of health services, and result in sustained improved health and well-being of Kenyans.

Data Triangulation Study

The primary objective of this assignment will be to use existing data for review and analysis. Rather than drawing conclusions from a data set/survey, the consultant [s] will be required, use multiple data sources to generate a data summary. Against this background, this activity will aim to provide benchmarked information on all project indicators to set a basis for measuring project success and progress. Specifically, in collaboration with the program team, using the ‘public health triangulation approach[1],[2]’, the consultant will

1. Identify key questions for investigation (for both phases of the initiative)

2. Ensure question(s) are important, actionable, answerable and appropriate for triangulation

3. Identify data sources and gather background information, including but not limited to the Kenya Demographic Health Survey Data, Kenya AIDS Survey Data, Population and Housing Census Data, Economic Survey Data, Multiple Indicator Cluster Survey Data.

4. Refine the questions

5. Gather data/reports

6. Assess data reliability and make observations from each data set

7. Note trends across data sets (with a focus on specific geographical areas) and hypothesize

8. Check (corroborate, refute, modify) hypotheses

9. If necessary, identify additional data and return to Step 5

10. Summarize findings and draw conclusions

11. Communicate results and recommendations

12. Finalize and submit final report with indicator summaries and values

Program Indicators

Below, is the list of program impact and outcome level indicators that will be subjected to triangulation. It is recommended that both qualitative and quantitative data be used. As much as possible, all data should be disaggregated by the lowest political unit [e.g ward], sex, age.

Table 1: Equity Afia Program Indicators

Impact: Sustained improvement in the health and well-being for Kenyans

Impact: Number of disability adjusted life years

Impact: Percent of individuals that does not experience catastrophic health expenditure

Impact: Percent of individuals reporting improved quality of life

Impact: Percent of men and women aged 15-49 who received an HIV test in the last 12 months and who know their results (and on ARTs? And sustained on ART?)

IR 1: Service delivery channels increased for sustainable delivery of quality health services

IR 1.1: Increased financing of private health care facilities

Outcome: Percent of Equity Afia Franchisees recording profits

Outcome: Percent of Equity Afia Franchisees receiving affordable loans

IR 1.2: Improved health services through management systems

Outcome: Percent of Equity Afia Franchises using an EQA management system [by type]

Outcome: Percent [number] of individuals referred [by type of service referred for] that received services

Outcome: Percent of EQA clients reporting satisfaction with health services (especially costs?)

IR 1.3: Strengthened human resources for quality health services

Outcome: Percent of Equity Afia Franchisees receiving technical assistance and capacity building to provide health care

Outcome: Percent of Equity Afia health facilities with minimum compliance levels to operational protocols

Outcome: Percent of EQA Franchise Staff with change in knowledge score after training (training means induction?)

Outcome: Percent of franchise with documented routine supportive supervision visits supported by Equity Afia

Outcome: Percent of Equity Afia-supported franchise sites implementing quality improvement plans

IR 2: The utilization of affordable and quality health services, products and information increased

IR 2.1: Increased availability of affordable and quality high-impact health care interventions

Outcome: Percent of Equity Afia franchises offering comprehensive health care services

Outcome: Percent of clients seeking services from EGF clinics who are from the lower 3 wealth quintiles of Kenya

Outcome: Percent of clients seeking information from EGF clinics who are from the lower 3 wealth quintiles of Kenya

IR 2.2: Increased awareness of integrated package of quality high-impact health interventions and related products

Outcome: Percentage of clients reporting knowledge of facility from an activation event or other communication events

IR 2.3: Increased uptake for an integrated package of quality high-impact interventions

Outcome: Percent of EQA clients requesting an HIV test, receiving a test and receiving test results

Outcome: Percent of EQA clients requesting other EQA health packages (e.g. well woman, well baby etc)

IR 3: The ability of Kenyans to withstand health risks and shocks improved

IR 3.1: Increased availability of health insurance and related products

Outcome: Self-reported insurance coverage

Outcome: insurance coverage from external sources e.g. EIB, studies

Outcome: Self-reported or objective reports of use of health savings schemes

IR 3.2: Increased utilization of health insurance and related products

Outcome: Percent of EQA clients who pay for health services with health insurance

Outcome: Percent of EQA clients who pay for health services with EQA health insurance

Key Activities and Deliverables

The baseline survey will start upon signing of the contract and non-disclosure agreement between Equity Group Foundation and the consultant/firm or an otherwise agreed upon date. The due dates for all deliverables will be finalized by the evaluator and Equity Group Foundation prior to submission of the inception report/work plan. Key deliverables include

1. An inception report including a technical proposal with methodology as agreed on with EGF Health Pillar in discussions following award of contract, clear work plan indicating key outputs persons allocated for implementation at each stage, and budget in Kenya Shillings prior to engaging in field work.

2. An initial report (word document) and power point presentation of preliminary findings from the assessment in relation to the above result areas and indicators done in a presentation to EGF team

3. A power point presentation, a soft copy and 2 hard copies of the full report of the final findings from the baseline assessment. The report should clearly present a summary of all indicators and baseline values for the respective indicators and should incorporate feedback from the initial powerpoint session.

4. Presentation of baseline findings at a dissemination workshop for the stakeholders

Suggested Report Structure

1. Title page

2. Contents page

3. List of abbreviations and acronyms

4. Executive Summary (maximum 2 pages, clearly summarizing the assessment and key findings)

5. Background (maximum 3 pages on the context of the intervention and project objectives)

6. Methodology (maximum 3 pages detailing what data synthesized, how it was collected and by whom, what the sample size was, any possible limitations to the assessment etc.)

7. Findings and analysis (approximately 15 pages giving the results of the assessment according to the objectives given in this ToR, combining qualitative and quantitative data, disaggregated by sex and age. The Findings section should also include a summary table showing updated information for program indicators)

8. Conclusions and/or Recommendations (approximately 4 pages, conclusions and recommendations must be clearly related to the evidence given in the Findings section of the report.

9. Annexes:

These might include: · Itinerary/ schedule

• List of people and organizations consulted
• References / list of documents/data reviewed
• Additional methodological information if required (e.g. more detailed information on sampling used for the research)
• Additional maps, photos or more detailed case studies if available
• Not in the actual report, but all raw data (quantitative data files etc.) should also be submitted for reference and future use. Profile of the Consultant

We are looking for a consultant/firm with the following skills and qualifications:

• Basic education qualifications in health systems research/evaluation, or public health or epidemiology or social sciences research
• Referenced (provide referee for assignment) experience of conducting similar assessment or work including program evaluations in the area of health for large-scale, regional or national level projects or programs in the last three years in Kenya
• Knowledge of health data and sources in Kenya
• Demonstration of experience as lead person/s of using and conducting literature reviews or data synthesis for service availability, readiness and quality of services
• Good report writing and oral communication skills
• Timely delivery of expected outputs from assessment
• Knowledge and experience of using statistical packages for analysis of data

Other attributes

The consulting firm or consultant (s) will be selected on the basis of their proven experience, qualifications and ability to deliver a quality product in a timely and efficient manner. Particular qualifications and experience of the lead consultant team members include:

• Post graduate qualification in Health systems research, Epidemiology or public health and at least 8 years of relevant experience ( Team leader);
• Excellent communication skills, especially ability to write very well in English.
• Excellent knowledge of issues in health programming and health systems in Kenya

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Background

Kenya envisages being a developed nation by 2030. This calls for increased transition rates from primary to secondary school in all districts to meet its anticipated middle and high level manpower requirements. However, transition rates from primary to secondary school in some districts remain low despite the government effort to offer tuition free secondary education and this situation affects adversely the poor and the vulnerable in the society by limiting their access to secondary education. It is against this backdrop that the Equity Group Foundation was established.

Equity Group Foundation [EGF] was established in 2008 in recognition of the need to scale up the existing corporate social responsibility [CSR] initiatives by Equity Bank Group. The Foundation acts as the institutional home for the Group’s social initiatives and interventions. Since its inception, the Foundation has significantly enhanced the coordination of social development interventions for the Group. The Foundation’s aim is to catalyze the socio-economic prosperity of the people of Africa by giving opportunity to the millions at the bottom of the pyramid to be incorporated into the modern economy.

Promotion of improved transition rate from primary to secondary education is at the core of the foundation objectives and academic performance in school is of major concern for the foundation and other stakeholders including; partners, teachers, parents, and the government since it influences the transition rate to higher education opportunities and charting of career pathways.

The Wings to Fly [WtF] Program

The Equity Group Foundation [EGF], is a not-for-profit implementing foundation arm of the Equity Group Holdings Limited that champions the social and economic transformation of the people of Africa. To achieve its mission of championing the transformation of lives and livelihoods through the development and implementation of innovative programmes that leverage existing infrastructure and link partners to the bottom of the pyramid, EGF designs and delivers high-impact social development programmes across seven strategic pillars. Of one of these pillars is the education & leadership development pillar, which primarily aims to increase access to and transition through secondary and tertiary education as well as provide leadership and career development for the next generation of leaders. It is under this program that the Wings to Fly [WtF] program resides. The WtF program has thus far provided scholarship support to 12,488 individuals, of which 3,578 have successfully completed the four years of Kenya secondary school since 2010.

Annually, students qualify to apply to WtF based on both academic performance and level of need. Applicants must be in the top fifth percentile on the nationally-administered Kenya Certificate of Primary Education [KCPE] examination in their home district to be considered. Meanwhile, level need is determined based on economic status and vulnerability, including as affected by the loss of one or both parents; parental illness or disability; and/ or displacement due to disaster or civil conflict. Equity Bank branch staff and local community leadership play a central role in vetting and ultimately selecting candidates by leading a transparent, community-owned process to interview and visit each prospective scholar and their families. This ensures that scholarships are actually benefiting those in need.

EGF and its partners stay involved to support students’ academic success once they are selected and enrolled in school. Each scholar receives mentoring throughout the year to provide emotional support and encouragement. In addition, EGF holds an annual Education and Leadership Congress, where scholars spend time learning from successful professionals from the public and private sectors. To date, the program has supported 12,488 scholarship beneficiaries in over 600 secondary schools nationwide courtesy of the generous support of the partners and Equity Bank.

Purpose and Scope of the Consultancy

Equity Group Foundation places great importance on the role of evaluations in providing basis for decision making, learning and implementing quality programs for evidence-based results. It is against this background that the foundation is interested in establishing the factors influencing academic performance of WtF Scholars primarily the socio-economic and environmental factors, among others that are likely to adversely affect the scholar academic performance. It is anticipated that the findings of the evaluation report and its recommendations will be instrumental in the implementation of an informed and effective mitigation measures in promoting excellence in academic performance.

The scope of the evaluation shall be limited to the current WtF scholars in various secondary schools in Kenya, scholars in all classes [form 1 to form 4], stakeholders in the program including the relevant Government institutions, Equity Bank, Parents/guardians and partners. The evaluation will use mix methods including primary research and secondary research approaches. Academic performance in this context will be regarded as the scholar performance during the internal exams while attending the four year secondary school course and also the performance at the National examinations [KCSE].

Objectives

1. Determine the actual causes of scholars’ low academic performance

2. To establish how school learning environment influences academic performance for the WtF scholars i.e. Level of school, physical facilities, teaching and learning materials, assessment of achievement, completion of the syllabus and teacher- student ratio.

3. Establish strategies that can be adopted to improve performance

Evaluation Questions

1. Does demographic factors, such as age, sex and family socioeconomic status influence his/her academic performance? Is there a difference in academic achievements of boys and girls?

2. To what factors do students attribute low academic performance?

3. How often does each of these causes of low performance occur among students?

4. What are the attitudes of students towards the low academic performance?

5. Does the provision of supplementary learning materials influence academic performance in way and to what extent?

6. Does the scholarship package [tuition and wrap around services] provided by the program influence the academic performance of the scholars?

7. Does the KCPE grade of the scholar influence future academic performance in internal exams and National Examinations?

8. How does the students’ characteristics influence their academic performance i.e. student attitude towards learning and students discipline?

Methodology

The technical proposal presented by the potential consultancy firms is expected to provide a brief presentation of the methodology to be used in the evaluation including design and justification on the use of the design. It is expected also under the methodology section that a description of the proposed sampling methods and procedures applicable to the evaluation is made. The detailed methodology and evaluation plan shall be presented at the inception report by the successful consultancy firm is contracted and this shall be discussed with the relevant EGF staff before the actual evaluation kicks off.

Expected Deliverables

· Inception report after contracting and before the actual evaluation.

· Draft evaluation report.

· Copy of the raw data used in the analysis.

· 1 day presentation of the draft report to EGF for feedback

· Final evaluation report[3 printed copies and a soft copy]

Evaluator Responsibilities

The evaluator will work with the EGF General Manager- monitoring and evaluation and other M&E staff to agree on a final methodology at inception stage and finalise on the budget if need be. The evaluator shall liaise with the EGF staff to identify and mobilise the relevant stakeholders, develop data collection instruments as appropriate, and to ensure the evaluation team has adequate access to relevant documentation. Periodic project management meetings with the M&E unit staff will be held as appropriate and provide guidance and feedback on the preliminary results and the draft report to ensure accuracy, relevancy and utilization of the findings.

The evaluator will provide his/her own working space and associated resources. It also expected that the budget is inclusive of all the costs when submitting their financial proposal to including; accommodation, communication, daily living allowances, transport and professional fees.

Proposed outline of the Evaluation Report

· Title page and cover photo

· Acknowledgment

· Executive Summary

· Introduction

· Program Description

· Objectives of the evaluation

· Methodology

· Findings

· Conclusion

· Recommendations

· Use, dissemination, and sharing plan

· Annexes

Desired Qualifications

· The consultancy firm must be a legal entity.

· The firm must provide demonstrable experience in similar assignments carried in the recent past 5 years.

· The lead consultant/investigator must be a PhD holder in either Education, research methods, development studies or a relevant discipline.

· Proficiency in quantitative and qualitative research methods is a key requirement

· Relevant geographical experience ideally in Eastern Africa and especially in the education sector.

· Excellent verbal and written communication skills in English and proficient in Kiswahili will be added advantage.

Application Requirements and Selection process

The Equity Group Foundation invites bids from a number of possible evaluators [individuals and firms]. Bids should include the following:

· A cover letter introducing the evaluator/ firm and highlighting the capabilities, skills and competences relevant to the evaluation.

· A detailed outline of the proposed evaluation process including the conceptual framework, proposed methodology and evaluation plan.

· Proposed budget for the evaluation[all costs inclusive of applicable taxes]

· A sample evaluation report relevant to the thematic area.

· A CV detailing relevant skills and experience of no more than 5 pages, including contactable referees [if a group, a CV should be submitted for each member of the evaluation team].

Criteria for selection will be:

· Quality of the methodological proposal: aspects that will help us to assess their suitability for that which is proposed in the RFP, quality of the proposal, feasibility, etc.

· Profile and competencies of the evaluation team: knowledge, experience, composition and other necessary competencies.

· Good understanding of thematic area of evaluation

· Time availability during the critical periods.

· Value for money.