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TERMS OF REFERENCE FOR INDIVIDUAL CONTRACTOR

Rapid Assessment, Adolescents, HIV/AIDS and SRHR

Assignment Title

Rapid Assessment: Adolescents, HIV/AIDS and SRHR in the counties of Kilifi and Makueni

Purpose of Assignment

The rapid assessment is intended to give county context in identifying equity and performance gaps limiting HIV prevention, treatment and care results and sexual reproductive health and rights in adolescents (aged 10 – 19) that would help define priority actions to accelerate and improve the quality of the county response to HIV among adolescents and hence contribute to the national response.

Location of Assignment

Nairobi, Kilifi and Makueni

Supervisor

Chief HIV Section, UNICEF Kenya

Duration of consultancy

25 days

Background

The United Nations Joint Programme on HIV and AIDS in Kenya, in an effort to ensure more focused and prioritised support to the national HIV and AIDS response, has set aside resources for supporting county level actions. Under the global Unified Budget, Results and Accountability Framework (UBRAF), the Joint Team developed a joint work plan to support the national response, in line with the Kenya HIV and AIDS Strategic Framework and in consultation with key national partners. A prioritisation of the work plan, based on an analysis of key gaps and priorities, was done to identify areas where the UN can add value within its comparative advantage of skill sets and mandates, while delivering as one.

One area which has been identified for focused support to counties is HIV Prevention among adolescents and young people (AYP) and Sexually Reproductive Health and Rights (SRHR). HIV infection among AYP in Kenya is still very high at 46% of all new infection in 2016. Young women and girls are most affected, contributing to 32% of all new infections. This is due to multiple factors including a major gap in comprehensive information on HIV and AIDS, early sexual debut, low condom use, low uptake of HIV testing and treatment services, and lack of youth friendly services for sexual and reproductive health and rights, among others. Moreover, young people living with HIV are facing poor treatment outcomes resulting in a high number of deaths. Other factors such as stigma and discrimination, high risk behaviours (e.g. alcohol and substance abuse, unprotected casual and transactional sex) and gender-based violence also contribute to the risk for HIV infection among young people. Moreover, certain groups of young people are also left behind in accessing HIV services such as young key populations (men who have sex with men, sex workers, injecting drug users), adolescents who are sexually exploited, young people in prisons and in refugee camps.

The activities to address this area will of course be tailored to county priorities as set out in County HIV and AIDS Strategic Plans (CASP).

Due to limited resources, the Joint Team together with Government decided on the selection of two counties to provide this support, based on set criteria that looked at the general epidemic; the epidemic among adolescents and young people; access to HIV testing and treatment and SRHR services; number of key populations, county HIV budgets and presence of other Joint Team programs. The two counties selected are:

• Kilifi, which has an adult HIV prevalence of 4.5% and the estimated number of key populations is 4,676. The number of adolescents and young people living with HIV is estimated at 8,800 with an additional 747 new infections among this group in 2016. ART coverage among adults is 63% and although no breakdown is available for men, about 35% of men in Kilifi have never tested for HIV. The Joint Team therefore proposes to work in Kilifi because of the focus on key populations, in particular people who inject drugs, and the engagement of UN agencies already working in the county.
• Makueni, which has an adult HIV prevalence of 5.1% and the estimated number of key populations is 1,966. The number of adolescents and young people living with HIV is estimated at 2,865 with an additional 831 new infections among this group in 2016. The estimated HIV prevalence among 15-24 year olds is 1.0%. ART coverage among adults is 56%. The Joint Team therefore proposes to work in Makueni because it is also a transport corridor hot spot.

Specific Tasks

• Conduct a desk review of relevant HIV and AIDS related epidemiological estimates and context for adolescents to illustrate the current situation in both counties.
• Provide background and analysis on availability and uptake of current HIV and SRH services for and by adolescents and young people. Identify key gaps and opportunities for improvement.
• Hold focus groups discussions with caregivers, adolescents and young people, including those most at risk (sexually exploited, engaged in sex work, injecting drugs and young men having sex with men) to obtain qualitative data on HIV related risks, availability and quality of HIV and SRHR services provided. Identify key barriers preventing access and use of services.
• Conduct stakeholders and beneficiary interviews including community leaders, health care service providers and representatives of adolescent and youth organizations to identify potential areas and types of involvement of adolescent and youth participation in the HIV/SRHR.
• Collate and analyse data collected and draft report with recommendations for action.

Expected Deliverables

• Compiled findings from desk review completed.
• Updated situation analysis on availability services for adolescents.
• At least four focus group discussions held with adolescents and caregivers (two in each county).
• At least six interviews held with stakeholders and beneficiary (three in each county).
• One concise report on key findings and recommendations that will help improve the lives and well-being of adolescents and young people as they relate to HIV and SRHR.

Supervision

The consultant will work under the overall guidance and supervision of the Chief HIV Section, UNICEF Kenya.

Collaboration

As the work cuts across a number of agencies under the UN Joint Programme on HIV arrangements, UNICEF will work in collaboration with UNAIDS and UNFPA on this assignment.

Duration of Assignment

It is expected that the entire assignment will be undertaken over a period of 25 working days as detailed below:

Desk review and preparatory work for the assessment, i.e. stakeholder briefings and logistical discussions: 4 days

Assessment of service availability: 3 days

Focus Group Discussions, including preparation and data compilation: 6 days

Stakeholder interviews, including preparation and data compilation: 7 days

Report writing: 5 days

Total: 25 days

Qualifications and Experience

• Master’s degree in Public Health, Sociology, Psychology or other relevant qualification
• At least 5 years of work experience in the field of HIV/AIDS/SRHR and adolescents and young people with a focus on conducting assessments, surveys and research
• Previous experience working with UNICEF and other UN agencies
• Results oriented with strong organizational skills
• Cultural and gender sensitivity
• Excellent command of spoken and written English

Remuneration

The consultancy fees will be paid in two tranches:

• 25% after the submission of the first two deliverables (desk review, situation analysis on services)
• 75% upon satisfactory completion of the assignment.
• Consultants are requested to develop a detailed assessment proposal which encompasses all costs including travel to and from Makueni and Kilifi.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.