Consultancy: Equity Assessment on Maternal and Newborn Health

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Organization: UN Children's Fund
Closing date: 21 Sep 2015

The Young Child Survival and Development (YCSD) section, UNICEF East Asia and Pacific Regional Office is seeking an individual consultant to conduct an equity assessment on the service coverage of Maternal and Newborn Health (MNH) and key MNH outcomes in the region, with the application of the organization’s Monitoring Results for Equity System (MoRES) approach.

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There are increasing focus and concerns regarding the equity in the access and use of MNH services, globally and particularly in the East Asia and Pacific. Consequently, the status and improvement of such health outcomes demonstrate significant variations across countries in the region and at the sub-national level, highlighting the importance of equity perspectives. UNICEF has been accelerating the application of the Monitoring Results for Equity System (MoRES) approach since its development in 2010, as a part of the organization’s increasing focus on equity. The MoRES has been integrated into the programming processes, during the Mid Term Reviews and a situational analysis for the Country Programme Document development. However, the employment of the MoRES has not been always sufficient and mostly partial, without addressing the complete sets of 10 determinant framework as per the global framework (i.e. enabling environment, supply, demand, and quality). Previous reports and empirical studies have provided a general understanding of inequity, for example, disparities in use of MNH service use and outcome by wealth. Yet most of the studies focus on only a single perspective (e.g. wealth) using descriptive statistics, thus evidence is limited to understand the magnitude of equity across multiple perspectives (e.g. wealth, residence, and else) and across countries in the region. To address this complex question, it is necessary to employ relevant and varied analytic approaches, including quantitative (multivariate analysis and meta-analysis) and qualitative (in-depth investigation of contextual and cultural aspects). Such evidence is critical in programming, planning, and monitoring and evaluation at the country and regional levels for addressing key bottlenecks to improve MNH with prioritization.

Purpose of Assignment:

i. Examine the equity situation at the country level according to the ten-determinant framework of MoRES and by key socioeconomic status.Under this specific objective, analyses would be conducted in two folds: 1) identify specific indicators and collect information per the MoRES ten-determinant framework (i.e. enabling environment, supply, demand, and quality) to assess equity, analyze and present findings at the country level (e.g. descriptive analysis); 2) examine the equity of MNH service use and outcomes (e.g. Antenatal Care (ANC), Skilled Birth Attendance (SBA), early Postnatal Care (PNC), etc.) by key socioeconomic status using existing population-based survey datasets such as DHS and MICS (e.g. wealth, residence, age, and education), using multivariate regression analyses. This analysis would be conducted for all the selected target countries for this assessment.

ii. Compare the equity situation in MNH service use and outcomes across the sub-national level (in selected priority countries).This analysis is built on the preceding analysis 1 in order to assess the situation of equity in a more in-depth manner. This sub-analysis considers sub-national variations (e.g. region, district) only in selected priority countries where inequity is an elevated concern based on key MNH outcome indicators (e.g. Maternal Mortality Rate (MMR), Neonatal Mortality Rate (NMR), and Infant Mortality Rate (IMR).

iii. Compare the magnitude of such inequity by key socioeconomic status across countries (using a meta-analysis).This analysis is built on the analysis 1 above, particularly of the second part. Using the estimates of the magnitude of inequity by the key sociodemographic variable, a meta-analysis would be conducted for each equity perspective (e.g. wealth, residence) in order to assess and compare its effect size on MNH service use and outcomes across countries in the region (e.g. compare the effect size of inequity in wealth as it affects ANC use).

iv. Using a qualitative approach, explore and analyze the inequity by selected contextual and cultural aspect (in selected priority countries).Given the fact that the sociocultural factors also greatly influence equity, some of which are highly contextual and cultural (e.g. ethnic minority/majority), a qualitative would be undertaken in the selected priority countries study (e.g. in-depth interview, focus group discussion) to understand the situation of inequity grounded sociocultural factors and to explore approaches addressing such bottlenecks.

v. A synthesis of the mixed method analysis above, and provision of evidence-based recommendations for the selected countries and regional support. Based on the analysis and findings from the varied approaches above, in alignment of the MoRES approach, the assessment report should also include: 1) a synthesis of findings that provide patterns of equity/inequity based on empirical evidence from this analysis; and 2) consolidated and logical discussions on the interpretation of findings; and 3) concrete evidence-based recommendations for policy and programming at the national and sub-national levels, as well as for the regional support.

Work Assignment, Work Schedule and Expected Deliverables:

Main Tasks

  1. Inception – Desk/Document Review and Work planning

Task Details

  1. Develop Inception Report with detailed workplan, methodology for collecting, consolidating and analyzing data/information.
  2. Undertake a review of latest (global/regional) documents and papers on equity analysis on MNH.

Deliverables

1) Inception Report1 (Inception report to detail workplan, methodology (including specific indicators/measures/data sources), list of references (initial) for the assessment)

2) Overview paper (and presentations) on the equity assessment of MNH.

When

7 working days, by mid-October ‘15

Main Tasks

2. Collection and consolidation of quantitative data

Task Details

  1. Collect and consolidate data/information for the MoRES 10 determinant framework from the study target countries (to be identified).
  2. Download population-based survey datasets.
  3. Undertake consultations virtually with the country office staff and key stakeholders of the study target countries (plus Bangkok Regional Office).

Deliverables

3) Consolidated and organized data/information in shared folders for the study target countries for the 10 determinant.

4) Organized datasets of surveys in shared folders.

5) A summary record of country consultations (a spread-sheet as an annex fir the final consultancy report).

When

7 working days, till end October ‘15

Main Tasks

3. Collection of qualitative data in selected priority countries

Task Details

4.Conduct qualitative data collection for selected equity determinants in priority countries (to be identified).

Deliverables

6) Country mission reports (priority countries to be identified).

When

10 working days, till early-November ‘15

Main Tasks

4. Data analysis, and synthesis and interpretation of findings

Task Details

5.Analyze data, and synthesize and interpret findings from the empirical analysis in comparison to existing evidence.

Deliverables

7) A draft report of the equity assessment on MNH.

When

18 working days, till early December ‘15

Main Tasks

5. Presentation & Reporting

Task Details

6.Develop a final end-of consultancy report that includes the analysis, synthesis and interpretation/discussion, as well as recommendations.

7.Develop a power point presentation as a summary of the final report above.

Deliverables

8) A final end-of-consultancy report that is built on the draft report above (around 40 pages max).

9) A summary report of the assessment as a draft manuscript for publication (around 5000 words max).

10) A power-point presentation (around 15 slides/20 minutes max).

When

8 working days, till end-December ‘15

End Product(s):

  • A database (i.e. organized and consolidated quantitative/qualitative data in shared folders).
  • An equity assessment on Maternal and Newborn Health in selected countries and in the region, with the understanding of patterns of inequity, the synthesis and interpretation of evidence, and evidence-based recommendations at the country and regional levels. A summary report to be accompanied as a draft manuscript for peer-reviewed journals.
  • A power-point presentation slides on the equity assessment.

Estimated Duration of Contract:50 working days during the period of October – December 2015

Official Travel:The consultant will work at his/her own premises, with official travels to the selected priority countries (to be identified later).

Qualifications or Specialized Knowledge/Experience Required:

  • Master’s degree in Public Health, Public Administration/Policy or similar field;
  • At least 10 years of work experience relevant to the assignment;
  • Specialist knowledge, skills and substantive experience with assessment and research in MNH sector, particularly in multivariate analyses and a meta-analysis using complex survey datasets, with proficiency in statistical software (e.g. STATA, SAS);
  • Experience in MNCH policy and programming;
  • Experience of working with UN, UNICEF and other donor environment; prior working experience with UNICEF and familiarity with the equity focus and UNICEF’s MoRES approach;
  • Good knowledge of the political, economic and social contexts of the East Asia and Pacific Region would be an asset;
  • Good verbal and written communication abilities and editorial skills in English;
  • Ability in working independently and experience in being directly accountable to senior level decision-makers.

How to apply:

Application process: Interested applicants are requested to submit Application Package and Expression of Interest by 21 September 2015 to email: [email protected] detailing:

  1. Qualification and technical capacity (CV/P-11)
  2. Relevant work experience for undertaking this assignment
  3. A detailed work plan (outlining milestones with timeframe)
  4. Proposed methodology
  5. Financial proposal: Daily professional fee in USD

Only short listed candidates will be notified.

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