February 17th, 2010

Terms of References

for

The Final Evaluation of

CARE Bangladesh’s

ARSHI PROJECT

(funded by the European Commission)

I. Background Information

Adolescents’ and Women’s Reproductive and Sexual Health Initiative (ARSHI in Bengali means Mirror which connotes a tool for self-discovery and transformation) is an EC funded initiative with the aim to decrease maternal mortality, morbidity and disability under two the main streams - health and social justice. Initially designed as a project solely focused upon increased awareness, access and utilization of maternal health facilities, the project has evolved to address the more insidious causes that result in maternal mortality and morbidity.

Women’s health and health seeking behaviour is rooted in religious, social and cultural beliefs and attitudes. ARSHI’s social change promotion approach engages men and boys,along with girls and women, to work together to empower girls and women in ending SGBV (sexual and gender based violence) and SEA (sexual exploitation and abuse).

Overall Purpose: ARSHI’s main purpose is to “Reduce maternal mortality and morbidity of women and adolescents”.

To achieve this goal, the initiative has the following four specific objectives:

  • Strengthened maternal and SRH service delivery access to such services in the project areas
  • Increased adolescents and mothers’ knowledge and improved attitudes/practices on maternal health and SRHR
  • An enabling environment has been created: gender attitudes and social norms have been changed in participating communities through social empowerment process
  • Increased commitment at national level for improved and context specific implementation of ‘national maternal health’ and ‘adolescent reproductive health’ policies in remote and undeserved areas like Sunamganj

ARSHI serves as a catalyst and as facilitator to erode the social and cultural perceptions that prevent women from developing healthy self images. At the service provider level, the project works to enhance their technical knowledge and skills and their ability to understand the deeper causes of neglect of women’s health care. Active community participation in analysis of issues, identification of resources and creating mechanisms to access health care are critical to the project approach.

In addition, in selected villages, the project has adopted the following strategies to address women’s health issues:

  • Community-led Total Health Justice Initiatives (CLTHJI)– This component addresses the lack of access of communities to health care and information through community capacity building and community led movements to reopen non-functional health posts and gradually strive to improve quality and range of care/access and making authorities accountable or responsive.
  • Community-led Total Social Justice & Change Initiative (CLTSJCI)–This approach addresses the low position of women and girls in the society due to social and religious norms that deny women and girls their basic rights to education, health and nutrition, and makes them vulnerable to maltreatment and violence at family and community levels. This approach engages men and women and girls and boys simultaneouslythrough community engagement and leadership building activities.

ARSHI’s advocacy agenda is being implemented in alliance with other regional and National NGOs to create awareness around specific topics that need the attention of policy makers.

ARSHI is being implemented in the north eastern district of Sunamganj since January 2007. There was a delay in project start up and the activities began from January 2007. The project has received a no-cost extension of one year and will now end in June 2010. The project is based in 10 sub districts with the target population of 1,40,000 Women ( 15-49), 72,000 adolescent girls and 72,000 adolescent boys.

II. Factors affecting the Final Evaluation: Since the design of the project, there have been major changes in the conceptualization of the project. The following changes will have a major bearing upon the design of the final evaluation:

  • From service delivery to community, women’s and youth empowerment: This has been a major change in the project and as a result the activities have been redesigned to achieve the overall objective. In addition to the conventional approaches to adolescents and women’s health, the project has also worked intensively in selected villages using the CLTSJI approaches.
  • Revisions in the log frame:While the overall objective of the project remains the same, the strategic objectives have been modified to reflect revised strategies. The revised log frame (attached with the ToR) shows the changes in the goals and indicators.
  • Relevance of the baseline survey:The baseline survey covered indicators that might not be relevant now. The final evaluation study design will have to compensate for the absence of baseline data to determine attribution of findings to ARSHI.

III. Purpose of the Final Evaluation: The Final evaluation will determine the combined outcomes of the project activities on women’s and girls’ health and health seeking behaviour. The final evaluation will examine the contribution of ARSHI in achieving these changes and determine how ARSHI has contributed to the changes. A cross sectional quantitative survey will be conducted. The quantitative data will be supplemented by in depth qualitative data to help understand the process of change.

  1. Specific Tasks:

The following is a list of activities that needs to be carried out for the final evaluation:

-Develop a research framework that captures the current approaches and expected outcomes and its linkages with CARE Bangladesh’s impact statements.

-Design a study to determine project outcomes on women’s and adolescent girls’ health and hygiene. Examine the hypotheses between outputs, and outcomes and outcomes and impact.

-Identify the extent of reducing early child marriage, earlyand repeated pregnancies.

-Identify the role of men and boys in creating a supportive environment for women and girls.

-Determine the relative effectiveness of the various approaches and provide plausible explanations for the findings. Identify approaches which have been successful and those that need to be a part of the core agenda for CARE Bangladesh for future projects on Adolescent and Women’s Reproductive Health.

-Determine the contribution of the project to CARE Bangladesh’s program approach.

-Assess the sustainability of the positive outcomes at social and institutional levels.

-Identify the extent to which sustainability at social, institutional levels has been created

-Determine the areas where ARSHI has had limited success and provide explanations for this.

V. Scope of Work

The Final Evaluation team will conduct a thorough review of the ARSHI project, including but not limited to:

  • Desk review of proposals, reports, studies, dissemination material
  • Field visits to understand project dimensions and scope.
  • Review of M and E data collected by the project
  • Develop and discuss the research framework with project and PNGO staff
  • Discussion with key CARE Bangladesh team, including senior management, Program Quality group, European commission and other stakeholders.
  • Review of existing M&E data stored at the central and regional levels
  • Develop and conduct study on selected topics, or to verify certain information derived from other sources. The study design will be finalized and agreed between the Final Evaluation team and CARE, after the draft plan is submitted to CARE.
  • Joint review of the analysis plan by CARE and the Final Evaluation team
  • Analysis of data
  • Preparation of draft report
  • Presentation of key findings
  • Finalization of the report based upon feedback from CARE Bangladesh

VI. Composition of the Evaluation Team

  • The Final Evaluation team will comprise of team members who have an appreciation of the local context and are specialists in sectors specific to ARSHI project. Specifically the team will have experts in the following disciplines; adolescents’ and women’s reproductiveand sexual health, provision of safe motherhood health care and community empowerment methodologies.
  • The proposed team members will have a demonstrated track record in carrying out evaluations in their respective areas of specialty.
  • The combined skill set of the team will include expertise in quantitative and qualitative methods.

VII. Deliverables

The Evaluation team will submit the following to CARE Bangladesh:

  • Study design and methodology based upon research framework
  • Time frame of activities
  • Analysis plan
  • Draft Report
  • Presentation of key findings
  • Final report based upon feedback provided by CARE Bangladesh

VIII. Timeframe

The Final Evaluation will take place from April -May 2010.

The draft report will be submitted to CARE no later than May 15th.

CARE Bangladesh will provide detailed feedback on the report by the May 22nd.

The final report will be submitted to CARE Bangladesh by May 31st.

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