mothers2mothers Job For In-Country Early Childhood Development Landscape Analysis

Purpose

This SoW outlines a request for the services of a consultant to support mothers2mothers (m2m) to conduct an in-country landscape analysis of the broad Early Childhood Development (ECD) context, programmes and best practices (national/regional - government, civil society and private sector) in Ghana. This will help to inform planning for inaugural implementation of m2m’s integrated ECD/RMNCH (Reproductive, Maternal, Neonatal Child Health) model in Ghana.

Background to m2m

mothers2mothers (m2m) is an Africa-based non-governmental organisation which believes that a healthy generation starts with mothers. From an initial goal of eliminating mother-to-child transmission of HIV, our model has evolved to providing family-centered education and support for reproductive, maternal, neonatal, and child health (RMNCH), focused on reaching the most vulnerable women and young children at the health facility, household, and community level. In 2017, with our partners, we enrolled nearly 2.3 million new clients into care across seven African countries, delivering services in health facilities and communities at over 1,000 locations, and employing 2,912 HIV-positive women as peer Mentor Mothers. In Kenya and South Africa, we have successfully scaled up our Mentor Mother Model through phased government adoption and ownership, and in 2018, we began a similar process in Mozambique.

The Mentor Mother model has been internationally recognised as a key strategy in effective RMNCH/PMTCT service delivery in the 2011 UNAIDS Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive. The Global Plan identified m2m’s Mentor Mother model as a key factor to achieving the Global Plan goals by 2015 and specifically included “women living with HIV at the center of the response” as one of four key principles for success.

Drawing on the Global Plan’s recommendations, responding to changing HIV/PMTCT, health system and funding environments, and incorporating learnings from our own operations research, m2m has broadened its programme focus from HIV-positive pregnant women, new mothers, and their families only to offer services and support to HIV-negative pregnant women, new mothers, and their families. m2m has enhanced its core PMTCT psychosocial peer support and education services to encompass comprehensive RMNCH and ECD care and is now providing services beyond the health facility, and delivering programmes at community level.

Elements of m2m’s enhanced package of services include Mentor Mother education, support and referrals for: TB, malaria, cervical cancer, nutrition (including measurement of mid-upper arm circumference), neonatal male circumcision and gender-based violence support. Mentor Mothers are successfully integrating these topics into their standard services – group health education, one-on-one and couples’ sessions, and support groups – and contributing to a more comprehensive continuum of care for pregnant women, mothers and their families. In 2015, m2m developed its first early childhood development programmes, and since 2018, has developed our ECD intervention further to become an integrated component of our standard programme, which is being increasingly rolled out across countries of operation.  

m2m’s Integrated ECD/RMNCH Model

There is a growing body of evidence on the importance of the provision of quality healthcare, proper nutrition, and psychosocial and emotional stimulation during early childhood as the foundation for success in future life. Children deprived of these influences due to poverty and associated risk factors including under-nutrition and inadequate stimulation, are likely to have lower educational attainment, lower adult income and poor parenting skills, thus perpetuating a cycle of intergenerational poverty and early childhood deprivation. The evidence posits that early and appropriate interventions, both in utero and during early childhood, can lead to positive outcomes, including raised cognitive, physical and social development, improved school performance, and enhanced future employment and earning potential. This social and economic return is beneficial for the individual, family, community and wider society as a whole.

Children who are exposed to HIV or who are HIV-positive themselves are frequently particularly vulnerable to risk factors and this cycle of deprivation. They are likely to be subject to multiple shocks (adverse events) and stressors (parental illness and death, parental stress and mental health reactions, reduced stimulation and child care quality) which can be extremely detrimental to their wellbeing and development. Data from a number of studies suggests that these children are likely to suffer adverse effects on their mortality, health, cognitive development and emotional adjustment.
Based on this growing body of evidence, m2m builds on the success of our PMTCT/RMNCH peer education and support programme, with the incorporation of ECD interventions to improve the health and development outcomes of our clients (pregnant women, mothers and children aged 0-3 years), enabling them to not only have healthy lives but also to thrive later in life.

m2m’s Ghana Programme

Inspired by our past work, with funding secured, in 2019 m2m will stablish ‘model’ sites at strategic geographic locations in Ghana, which will deliver our integrated ECD/RMNCH services and showcase this important work to government, funders, donors and partners. We will initiate our well-established process for start-up in a new country - conducting scoping research, recruiting key programme staff, establishing relationships with government and other key stakeholders, and identifying the best location for a model site then of course recruiting and training a cohort of Mentor Mothers.
 

Work to be accomplished

m2m requires a consultant to conduct in-country formative research and landscape analysis of the ECD/RMNCH context in Ghana. The proposed work to be accomplished under this consultancy consists of:

1.    Landscape Analysis in Ghana

Conduct formative in-country research on ECD context, programmes, best practices, key stakeholders to inform planning for inauguration of m2m’s integrated ECD/RMNCH programme in Ghana (focused on pregnant women, children aged 0-3 years and their parents/caregivers). The following key issues should be addressed:
•    Collate relevant country specific demographic information, seeking to identify geographic regions of high need, based on criteria such as HIV prevalence, economic vulnerability, etc.
•    What is the status of ECD/RMNCH-relevant policy (adoption, implementation, monitoring)?
•    What are the key government Ministries/units leading ECD/RMNCH and who are the key government stakeholders within those Ministries?
•    Who are the other key players (private sector, civil society; Ghanaian, international) in ECD and broader RMNCH within the country? What is their approach and how do they position themselves?
•    What ECD programmes currently exist in-country (government, civil society; Ghanaian, international)? Explore center-based, non-center based/community/health facility programmes and establish linkages with such programmes. What services are provided? What are the barriers to implementing ECD programmes in-country? Are there any challenges with integrating ECD into PMTCT/RMNCH services in-country?
•    What funding for ECD/RMNCH is available in-country?
•    Source existing empirical ECD studies focusing in-country.
•    In support of the baseline study to be commissioned as well as the institutionalization of a routine Programme Performance Management system, explore and document information on:
    o    The Ministry of Health’s Health Management Information System (HMIS), National Demographic and Health Surveillance (DHS) and additional data sources; data access, research stakeholders / potential research partners; policy environment as it relates to implementation of Digital Health; and infrastructure support for Digital Health.

2.    Convening meeting/making introductions
•    Facilitate key introductions at the country-level including to other partners working in the ECD arena, key stakeholders, and ministry contacts.
•    Organize and support key stakeholders forum  to introduce m2m to the Ghanaian context.
•    Represent m2m at local forums, as needed.

3.    Other tasks
It may be necessary to request further related tasks, to be agreed with the consultant, as needed.

Process

Methodology to include desktop research, document reviews, face to face meetings/interviews with key informants/stakeholders 

Desired Outputs & Payment
Payment to be provided on submission of output outlined below:
•    Landscape analysis report, to include (but not limited to) the following sections (NB – these sections/headings to be revised, as necessary, in collaboration with the m2m Liaison Officer):
    o    Brief executive summary
    o    Acknowledgements
    o    List of acronyms
    o    Contents list
    o    Introduction
    o    Country context, to include e.g.:

•         The situation of children (specifically 0-3 years), pregnant women and mothers in Ghana – include tables of data
•         Data re HIV prevalence – include data
•         Government administrative structure
•         Geographical context (relate to HIV prevalence/vulnerability) – include map/s

    o    Government responsibilities (ECD, RMNCH), national policy framework
    o    Parenting/ECD knowledge and practices in Ghana
    o    Existing ECD programming and services
    o    Existing RMNCH programming and services
    o    Key players in ECD – government/civil society/private sector
    o    Funders of ECD, RMNCH in Ghana
    o    Barriers to implementing ECD programmes in-country
    o    Recommendations – including: potential location/s for m2m’s programme; potential partners; key people to meet; next steps; and other recommendations, as useful
    o    Feasibility of using Digital Health / mHealth solutions
    o    Key Research Partners – commercial / for profit companies as well as academic / parastatal institutions, and recommendations for managing a baseline study.
    o    Appendices, e.g.:

•           List of key informants by type (with contact details)
•           Bibliography/references
•           List of relevant policy/legal documents with web links, where possible
•           A comprehensive list of Data Sources (Public Health) and relevant data access information

•    Completion of convening (organization, facilitation, etc.)

Period of Support

•    From 20 May 2019
•    Up to 40 days

Travel Requirements

Internal travel within Ghana, as necessary