HIVOS Country Expert Consultant Consultancy

Scope of Work (SOW) for Country expert: To lead data synthesis and Country-specific stakeholder engagement workshops on consent to access for health services for adolescents

1. Context analysis

Global commitments to achieve Sustainable Development Goals (SDGs), in response to ending poverty and accelerating development across sectors, including improving health and wellbeing, require efforts to bridge the equity gap. Within countries in sub-Saharan Africa (SSA), inequitable gender norms require sustained redress efforts, to access sexual and reproductive health (SRH) services, prevent adolescent pregnancy, and keep girls in school. Achieving health milestones and school progression to realize one’s full potential are socio-economic development imperatives in modern society, irrespective of gender power differentials and wealth constructs.

When women and girls are able to achieve their full potential, they are empowered to effectively contribute not only to their well-being but also to that of their families, the community, and their nations. However, in many low and medium-income countries (LMIC), including most countries in SSA, barriers to accessing health services, in particular SRH and reproductive rights, remain. Failure to access SRH&R information and services, often contributing to school dropout from early and unintended pregnancy could mark a journey cut too short, career prospects are curtailed for many.

Adolescent pregnancy remains an acute health and social problem in SSA. In 2019 according to WHO, there were 21 million pregnancies among adolescents aged 15–19 years globally; close to half of these pregnancies were unintended. Early and unintended pregnancy (EUP) remains a pressing concern with severe socioeconomic and health outcomes for adolescent girls aged 15–19 years, their offspring and society (WHO, 2021). An estimated 49 million sexually active women in East and Southern Africa do not have access to modern contraception or family planning services, and more than half of these are young women. Consequently, adolescent pregnancy rates in the region are twice the global average at 92 births per 1,000 girls (UNFPA, 2021).

Despite the negative consequences associated with adolescent pregnancies, there are persistent barriers that inhibit their access to health, particularly SRH services.Adolescents face several barriers inhibiting access to essential health services. These barriers range from cultural and social norms, including stigma surrounding SRH**, gender inequality** which often discourages adolescents from seeking care, youth-friendly care services are non-existent or not prioritized, poor health provider attitudes towards young people, limited privacy and confidentiality, economic challenges, including the inability to afford services or transportation, exacerbate access issues. Additionally, geographical barriers in rural areas make health facilities difficult to reach. Further legal and policy restrictions, like parental consent laws for contraceptives or age-based service limitations, prevent adolescents from receiving care, especially for sensitive health concerns.

Literature has also shown that climate-induced shocks, such as floods, droughts, and storms, can also affect adolescents’ access to health services. These climate-induced disruptions complicate transportation and communication, making it difficult to reach healthcare facilities. Additionally, climate shocks increase the burden on already strained health systems increasing the need for medical care due to injuries, malnutrition, and disease outbreak. Addressing these barriers is essential to improving adolescent health outcomes (UNICEF, 2019; WHO, 2020).

Using a human-rights-based approach, we are conducting an assessment to review data on the status of SRHR with a particular focus on consent to service access and the implications of climate-induced shocks on access to services, and how it impacts adolescent pregnancy and/or related outcomes in the East and Southern Africa (ESA) region, guided by a global assessment framework.

For the purpose of this study, the definition of adolescents is based on that of WHO, being age 10 – 19years.

1. In-Country Expert Scope of Work:

The In-country expert will be engaged to lead in the review and synthesis of country specific adolescent health related data, map out key stakeholders and facilitate Country-Specific Critical Thinking Symposia (Panel Discussions) focusing on Adolescent Sexual and Reproductive Health and Rights (ASRHR) and the impact of climate change related shocks on adolescents access to health services in selected countries. These symposia will bring together experts and key stakeholders from partner organizations working in adolescents to review adolescent pregnancy trends in the respective countries, discuss best practices in providing health services to adolescents, innovations in service provision, and identify challenges in reaching adolescents.

The in-country expert will be expected to map key stakeholders, identify critical literature for the review, document gaps and organize a high level panel discussion at the country level to engage experts to validate the lessons. Additionally, the expert will support the Principal Investigator to convene virtual discussions with regional working groups, such as SADC SRHR Secretariat, COMESA, and climate-health-related groups. These sessions will serve to stimulate critical thinking, share knowledge, strengthen multi-sectoral collaboration, and inform policy dialogue and advocacy efforts.

Specific activities for the role will include:

1. Developing a comprehensive directory of stakeholders per country who are actively working on adolescent health in the study countries
2. Pooling critical literature from study Countries that highlights country-specific progress towards addressing adolescent pregnancy
3. Facilitating virtual dialogues with regional working groups focused on SRHR, climate change, and health, aligning the discussions with regional policy frameworks and strategies.
4. Convening a critical thinking symposia to allow for collaborative problem-solving among partners working on adolescent SRHR issues.
5. To generate actionable recommendations for improving adolescent SRHR policies and programming.

The Country Expert will undertake the following key tasks:

1. Data Synthesis and Collation:
2. Key document identification
   • Support the review of grey and published literature of adolescent SRHR and climate related challenges to health access
   • Identify best practices, gaps and opportunities for improving young people’s health needs
3. Review country specific commitment to fulfilling obligations on core SRHR-related themes including addressing:
   • Access to contraceptive information and services;
   • Access to safe abortion and post abortion care services;
   • Maternal health care;
   • Prevention and treatment of HIV;
   • Comprehensive sexuality education;
   • Prevention of violence against women and girls; and
   • SRH rights of marginalized populations, particularly adolescents living with disabilities.

B. Planning and Coordination:

1. Initial Consultation & Inception:
   • Engage with key stakeholders, including the project management team, country-level representatives, and regional partners, to finalize the objectives, structure, and deliverables for the symposia.
   • Develop a detailed work plan with timelines and milestones for the organization of the events.
2. Identification and Selection of Panelists/Experts:
   • Collaborate with technical working groups on adolescent health and reproductive health to identify and invite 15-20 key partners or experts to participate in each country-specific panel discussion.
   • Ensure the inclusion of diverse perspectives, including government representatives, civil society, youth leaders, healthcare professionals, and regional and international experts.
   • Collaborate with regional organizations (SADC SRHR Secretariat, COMESA, etc.) to ensure their involvement in virtual discussions.
3. Logistics and Event Coordination:
   • Organize the virtual platform for the panel discussions (e.g., Zoom, Teams, or similar).
   • Provide logistical support to ensure smooth facilitation of the discussions, including managing invitations, coordinating speakers, and ensuring technical support.
   • Ensure that relevant materials, such as background papers, reports, and discussion guides, are shared in advance with participants.

C. Designing and Facilitating the Symposia:

1. Content Development:
   • Work with principle investigator to design the thematic structure for each panel discussion, ensuring the topics address pressing adolescent SRHR issues and reflect regional and country-specific priorities.
   • Create an agenda panel discussion, with clear objectives for each session, time allocations for each speaker, and time for audience Q&A.
2. Moderation & Facilitation:
   • Act as the moderator for the panel discussions, ensuring discussions are productive, inclusive, and aligned with the session’s goals.
   • Facilitate the engagement of experts, participants, and audiences through interactive Q&A, polls, or break-out group discussions.
   • Encourage critical thinking and the sharing of innovative solutions or approaches to common challenges in adolescent SRHR programming.
3. Engagement with Regional Working Groups:
   • Organize virtual discussions with regional working groups (e.g., SADC SRHR Secretariat, COMESA, and climate change-health groups) focusing on the intersection of adolescent SRHR with broader regional priorities.
   • Foster dialogue and collaboration between country-level stakeholders and regional entities to strengthen cross-border learning and policy alignment.

D. Reporting and Documentation:

1. Event Summaries & Reports:
   • Provide detailed post-event reports summarizing the key discussions, recommendations, and insights from each panel discussion.
   • Highlight the main findings and potential areas for action based on the critical thinking discussions.
   • Prepare a final synthesis report capturing the overall outcomes and recommendations across all symposia.
2. Recommendations for Policy & Program Development:
   • Consolidate actionable recommendations for improving adolescent SRHR policies, programming, and best practices based on the critical reflections during the symposia.
   • Provide recommendations on how to strengthen multi-stakeholder partnerships and improve the integration of climate change and health into adolescent SRHR programming.
3. Dissemination of Outcomes:
   • Coordinate the dissemination of event materials, key insights, and recommendations with relevant stakeholders and platforms (e.g., regional networks, SRHR partners, government agencies, and policy forums).
   • Ensure that the outcomes of the virtual discussions are shared with regional and international SRHR networks and incorporated into relevant policy briefs.

E. Monitoring and Evaluation (M&E):

1. M&E Framework:
   • Develop a monitoring and evaluation framework to assess the effectiveness of the symposia, including participant feedback and tracking progress toward the stated objectives.
   • Collect feedback from participants via surveys or interviews to assess the relevance and impact of the discussions on their work in adolescent SRHR.
2. Follow-up Actions:
   • Develop a follow-up plan to ensure the recommendations from the symposia are acted upon and inform future programming and advocacy efforts.

4. Deliverables:

1. Detailed Work Plan: Including timelines, milestones, and event structure.
2. Agenda for each panel discussion: Tailored to the needs of the specific country or regional group.
3. Participant and Expert list: 15-20 experts per country, identified and invited.
4. Event Facilitation and Moderation: Conducting the panel discussions and virtual sessions.
5. Post-Event Reports: Detailed summaries of key discussions and recommendations.
6. Synthesis Report: A consolidated report across all events with regional insights on Best practices for ensuring access to services, regional opportunities for accelerating progress and proposed Actions for National governments.
7. M&E Framework and Feedback: Collection of participant feedback and recommendations for improvement.
8. Dissemination Plan: Strategy for sharing event outcomes and follow-up actions.

5. Timeframe:

The Country expert will be expected to deliver the above-mentioned services within a period of 4 months from the date of contract signing, with the following key milestones:

• Inception Phase (Week 1-2): Finalize event plans and schedules.
• Planning & Coordination (Week 3-6): Invite panelists, finalize logistics, prepare materials.
• Symposia Implementation (Week 7-12): Organize and moderate country-level and regional discussions.
• Reporting & Follow-up (Week 13-16): Compile reports, recommendations, and disseminate outcomes.

6. Qualifications & Experience:

The Country expert should have:

• A Master’s degree in Public Health, Social Sciences, or a related field.
• Extensive experience in organizing and moderating panel discussions and symposia on adolescent health and SRHR.
• Experience working with regional organizations (e.g., SADC, COMESA, etc.) and knowledge of regional SRHR frameworks.
• Familiarity with climate change and its impact on health and SRHR, particularly with regards to adolescents.
• Strong networking and facilitation skills, with the ability to engage diverse stakeholders from governments, civil society, and the private sector.
• Proven ability to synthesize complex information and produce high-quality reports and recommendations.

7. Reporting:

The Country expert will report directly to the Principle Investigator. Regular updates and progress reports should be provided to ensure alignment with the project’s objectives and timelines.

8. Payment Terms:

Payment will be made based on the delivery of agreed milestones (all inclusive, including costs of stationery, internet, etc.), with detailed invoices submitted to the Principle Investigator for approval. Costs for convening the Country Specific symposium will be borne by the Council on a reimbursement basis. Specific terms of payment will be outlined in the contract

Deliverables

Deliverable 1: Detailed Work Plan

Deliverable 2: Agenda for Each Panel Discussion

Deliverable 3: Participant and Expert List

Indicator of Achievement

• Developed timelines, milestones and event structure
• Tailored to the needs of the specific country or regional group
• 15-20 experts per country, identified and invited

**Amount Percentage:**20%

Deliverable 4: Event Facilitation and Moderation

Deliverable 5: Post Even Reports

Deliverable 6: Synthesis Report

Deliverable 7: M&E Framework and Feedback

Indicator of Achievement

• Panel discussions and virtual sessions conducted
• Detailed summaries of key discussions and recommendations
• A consolidated report across all events with regional insights on Best practices for ensuring access to services, regional opportunities for accelerating progress and proposed Actions for National governments
• Collection of participant feedback and recommendations for improvement

**Amount Percentage:**60%

Deliverable 8: Dissemination Plan

Indicator of Achievement

• Strategy for sharing event outcomes and follow-up actions.

Indicator of Achievement : 20%

1. Intellectual Property

All data and written products produced under this consultancy will belong to Population Council, Inc

Tagged as: Kenya, Malawi, Population Council, South Africa, Uganda, Zambia, Zimbabwe