Terms of Reference

Development/ designing of Gender responsive, Nutrition integrated, Hygiene Behaviour Change (HBC) creative package for Healthcare providers and communities

Assignment Information

About WaterAid

WaterAid is an international not-for-profit, determined to make clean water, decent toilets, and good hygiene normal for everyone, everywhere within a generation. We have been working with government and non-governmental partners to ensure that these essential services are available to poor and marginalized communities, especially women, persons with disabilities, and vulnerable groups.

WaterAid employs a public health and climate adaptation approach to addressing current water, sanitation, and hygiene (WASH) service requirements and sustaining them for the future. Hygiene behaviour change, menstrual hygiene, rural and urban sanitation and safe water systems, WASH in institutions (healthcare facilities, schools, public places) and nature-based solutions for water conservation, groundwater recharge and waste-water treatment are some of the interventions used for achieving our objectives. We also work with sector partners to support and influence the behavioural, institutional and policy mechanisms for accelerating progress toward achieving safe and sustainable WASH access for the poor and marginalized communities.

For more information, please visit (www.wateraid.org)

Background

An estimate 53,000^[1] Pakistani children under five die annually from diarrhoea due to contaminated water, poor sanitation and hygiene practices, which can cause stunting that currently affect almost 44% of children in Pakistan.

Drinking water from 56.1% ^[2]of households in Pakistan is contaminated with coliforms^[3], about 36.0% of households in Pakistan drink water contaminated with E. Coli, the highest prevalence of E. Coli contamination is in KP-NMD is noted as 78.3%.

Most of these disease patterns and the morbidity and mortality attached accrue from lack of clean drinking water, sanitation facilities and hygiene awareness and practice

Women, adolescent girls, and children of the province are impacted by malnutrition due socio-cultural factors, poverty, gender inequality, and community norms.

The 2018 National Nutrition Survey reported that the critical high levels of malnutrition were consistent with the high rates of infant and maternal mortality. In 2019, the infant mortality in KP was 53 deaths per 1,000 live births, and maternal mortality was at 165 maternal deaths per 100,000 live births in 2019. A large proportion of these deaths are attributed to a prevalence of early childbearing, low birth weight and the high prevalence of malnutrition among pregnant and lactating women.

WASH services in healthcare facilities (HCFs) of Pakistan fall short of WHO and national standards; only 16% of HCFs have basic sanitation service, 55% have basic hygiene service, 14% have basic healthcare waste management, and only 35% have environmental cleaning, with evident neglect of inclusion (especially from gender and disability perspectives). Moreover, people attending healthcare facilities, particularly primary healthcare facilities are often perversely exposed further to WASH related health risks. 19% of non-hospital healthcare facilities have no water service and 32% have no hygiene service. Although 86% of all facilities have improved sanitation, 24% of these are non-functional and only 33% have gender-separated toilets. Low resourcing for Health and limited understanding of healthcare providers on the importance of WASH are two, out of the multiple causes of low achievements in health sector.

In order to contribute to improvement of WASH and Nutrition status of people, WaterAid Pakistan intent commence a Nutrition and Hygiene behaviour change project named Increase Gains in Nutrition by Integration, Education, Evaluation and Empowerment (IGNIT3) in district Swabi. The project aims to improve nutrition for the poorest and most marginalized, especially women, adolescent girls, and children, in Swabi, Khyber Pakhtunkhwa-Pakistan. IGNIT3 will address this by delivering targeted, integrated nutrition, health, and water, sanitation, and hygiene (WASH) programming to build sustainable institutional capacity of the target groups and improve nutrition within vulnerable communities. Formative research was conducted to understand current hygiene practices, behavioural determinants including gender norms, roles, social beliefs, motives & barriers and touch points etc. FR report and recommendations suggested development of a comprehensive, diverse HBC package for improvement of target behaviours among the target groups in communities and healthcare facilities. and power

Purpose of the assignment

The purpose of this assignment is the development of gender responsive, integrated nutrition, Hygiene Behaviour Change communication (HBC) creative package, that includes but not limited to customized interactive manuals for master trainers, healthcare workers/ Lady Health Workers and communities (men, women and adult boys and girls) following the creative package design workshop. The manuals will focus priority behaviours including hand hygiene, food hygiene, household water treatment and safe storage, human excreta management, waste management, food groups/ consuming balanced diet etc. The HBC package will also include development of different posters, sorting cards, games, case studies, puzzles, nudges and cues etc, with cultural appropriate visuals/ illustrations on the above-mentioned targeted behaviours. These resources will be used during training sessions with different target groups, social and electronic media campaign, and other interactive campaigns for improving hygiene and nutrition behaviours.

Scope of Work

Under this assignment, the individual consultant/firm responsible to:

• Desk Review of Existing Resources: Undertake desk research and analyse all the available national/provincial Nutrition related HBC packages, training modules, training materials to fully understand the scope of work and identify materials like games, cards, posters etc which are being used in current health and nutrition programs and which can be further used in developing the tailored, gender responsive, nutrition integrated HBC package.
• Review Formative Research Findings and Strategy/ proposed HBC material Thoroughly read   Formative Research report developed for the same project, also study in- depth the recommendations and strategy for subject HBC package.  
• Training on creating creative package designing

Based on the findings from FR research and HBC strategy, consultant is expected to conduct a two-day workshop on creative package designing, engaging stakeholders from different settings. Compile the discussions/ ideas to generate creative package. Also, the consultant is expected to develop a creative brief for the health facility and community settings.

• Gender responsive, Nutrition integrated HBC package development: 

• This include but not limited to:
  • Develop a comprehensive, gender responsive, interactive 4 days training manual for healthcare providers master trainers.
  • Develop a comprehensive 02-day training manual for lady health workers.
  • Develop interactive sessions modules for target groups in communities and healthcare facilities for 06 exposure visits targeting all agreed behaviours along with all supporting illustration, activities case studies, catchy title/ messages etc.
  • All manuals must contain separate modules for each priority behaviours target identified/ studied under formative research. Manual/modules should be supported by relevant images and interactive activities and scenarios/ case studies.
  • Develop/ design culturally appropriate posters/ nudges/ cues (different size), games, puzzles, case studies, visual stories etc around priority behaviours and different target groups and healthcare facilities as a part of the package.
  • Develop user guide -a guiding manual for trainers/ facilitators, contains clear agenda, mode of facilitation, material to be used with each session and how to conduct session and use HBC material developed/ activity designed for each session/each exposure.
  • All training manuals will is expected to be developed in English and translate into Urdu language while
  • Develop Pre/post-test.
  • Plan of action/ health facility improvement plan.

Deliverables

The following deliverables are anticipated as outcomes of the proposed consultancy.

• Desk review report including proposed topics and strategy to address the training needs of each target group.
• Based on the finding from formative research and HBC strategy, Conduct a two- day workshop on designing gender responsive nutrition integrated creative HBC package for different stakeholders engaging participants from different settings.
• Provide creative brief for health facility and community settings  
• Provide a gender responsive, Nutrition integrated HBC package- includes but not limited to:
• A comprehensive, gender responsive, Nutrition integrated training manual for master trainers who will be healthcare providers, for a duration of 4 days containing separate modules for agreed priority behaviour with relevant images and interactive activities and scenarios/ case studies title page, catchy title etc for each module.
•  A comprehensive gender responsive, Nutrition integrated 2-day training manual for Lady Health Workers that contains separate modules for agreed priority behaviour with relevant images and interactive activities and scenarios/ case studies catchy title for each module.
• Develop interactive sessions for each target group in communities and health facilities for 06 exposure visits targeting all agreed behaviours along with all supporting illustration, activities case studies, catchy title/ messages etc Provide separate interactive package/ IEC Content to be displayed in healthcare facilities and communities and for sharing on social media platforms. The IEC Content will be designed in 1:1 ratio and 1920 x 1080 dimension in Adobe Suite so that it can be used as per the needs.
• Provide user guide, a guiding manual for trainers/ facilitators on how to conduct session and use developed HBC package, activity designed for each session/each exposure. Any other required content as result of the formative research conducted.
• Provide all the complete package in English and Urdu languages.
• Provide Sessions’ plan for each manual and modules.
• Pre/post-test for each target group
• Action plan/ healthcare facility improvement plan sample/ temple.
• Provide editable/ source files to WAP including source files for all illustrations/ activities/ games etc.

Supervision

Project Coordinator IGNIT3 will be the focal point for this assignment for coordination however WASH and health specialist WaterAid Pakistan and communication coordinator will provide technical oversight on the content and branding of HBC package.

Duration of assignment

WaterAid intends to receive the services of a selected consultant with total level of efforts of 74 working days spreading over 4 months commencing from the agreement signing date.

Evaluation criteria

Each candidate shall submit technical and financial proposals in two separate sealed envelopes. Technical offers will first be evaluated according to the “Evaluation criteria” below and the technical qualification threshold point is “70”. Financial offers of ONLY successful candidates will be opened.

a.                                   Technical Evaluation criteria

b.                                  Financial offer

For financial offer, each deliverable must be included in the financial offer. All deliverables MUST be completed within the assignment duration.

Standard Contract Terms & Conditions

WaterAid practices the following terms and conditions stated below:

• Intellectual Property Rights in all documents/information/ other materials prior to the date of execution of an agreement pursuant to this bid shall vest in the Party to which such document/information/materials belong. 
• All Intellectual Property provided by WaterAid Pakistan to the Consultant for performing the obligations under the agreement with WaterAid shall remain the exclusive property of WaterAid Pakistan.
• Any reports produced/data collected, or any other Intellectual Property generated by the Consultant pursuant to or under the agreement with WaterAid shall be the exclusive property of WaterAid Pakistan.
• The vendor assumes all responsibility for complying with local legal codes as they apply to an Agreement and work performed there under. In addition, the vendor shall be liable to pay all applicable taxes and fees as required by the laws of government of Pakistan. WaterAid will deduct Income Tax and VAT at source as per Govt. rules.
• The vendor shall not without first obtaining the consent in writing of WaterAid, permit any of its duties or obligations made under the Agreement to be performed or carried out by any other person or reassign his/her interest in the Agreement.
• The vendor shall not hold WaterAid liable for any accident or misadventure befalling them whilst on duty or pursuing activities to fulfil the Agreement.
• WaterAid reserves the right to accept and reject any proposal without assigning any verbal and or written rationale whatsoever.