ToR for End-line Evaluation: Integrating youth Friendly clinic in youth empowerment Center project Phase II _at German Foundation for world population Ethiopia

BACKGROUND AND INTRODUCTION

a) DSW Background

German Foundation for World Population (DSW) is a global development organization that focuses on the needs and potential of the largest youth generation in history. We are committed to creating demand for and access to health information, services, supplies, and economic empowerment for youth. We achieve this by engaging in advocacy, capacity development and reproductive health initiatives, so that young people are empowered to lead healthy and self-determined lives.DSW has been working in Ethiopia for about two decades and half focusing on adolescent and young people sexual and reproductive health program in collaboration with government, international and local partners at different levels.

DSW Ethiopia is implementing various projects across Ethiopia, particularly in Oromia, Amhara, Sidama, Central Ethiopia, South Ethiopia, Afar, Somali and Addis Ababa in collaboration with different developmental partners and maintains a strong network of partners ranging from community-based structures, local government offices to national and international NGOs and federal ministries. Currently DSW Ethiopia is initiating the implementation of a new project titled “Integrating youth Friendly clinic in youth empowerment Center project Phase II” This initiative is a two year project, running from March 2024 to February 2026.

b) PROJECT BACKGROUND

In Ethiopia Adolescent and Youth Health was given attention and efforts have been exerted both by the government and partners to improve the situation. However, there is a high-unmet need, teenage pregnancy remained high for the last two decades, traditional practices and sexual and gender-based violence that aggravate the situation continue to be practiced, HIV infection is again rising and others. Limited knowledge on SRHR is one of the main factors that stop youth from accessing SRHR services. Even though youth have a great need for adequate knowledge on SRHR due to their age, their access to age-appropriate information and services is still very limited. The lack of awareness and knowledge about SRHR, specifically about sexual activities, methods of contraception and SGBV contributes to SRHR problems, including unwanted sex, forced marriage, unwanted pregnancies, unsafe abortions, STI and HIV. Their educational level, economic situation and socio-cultural affect their access to accurate SRHR information (AYH strategy 2021-2025).

Ethiopia is also committed to improving SRHR services, however, availability and utilization of family planning services by youth, in particular young women, remain very low and the quality of health care delivery systems remains poor. The median age of first birth among Ethiopian women is 19 years (EDHS, 2016). Many pregnancies are unintended, and the contraceptive prevalence rate is only 37 percent among women aged 15-19 years and 52 percent among women aged 20-24 years. Urban women are more likely to use contraceptive

methods than their rural counterparts. The rates are particularly low in the project target regions. In 2019, only 38.9 percent of all women of reproductive age (15-49) are using modern contraceptive methods in Oromia region (EDHS, 2020). Skilled delivery including for married young couples in the project regions, is also low. Norms and perceptions deeply rooted in society often discourage youth from seeking SRH services. In addition, there is high sociocultural pressure that girls and young women are facing to give birth which is an obstacle to the introduction of modern family planning approaches.

This project is an extension of Phase I. During the first phase of implementation, six Youth-Friendly Clinics (YFCs) were established. In Phase II, these six YFCs were expanded through the introduction of additional services, particularly laboratory services, and two new YFCs were established. The clinics report that comprehensive Sexual and Reproductive Health (SRH) services are being consistently provided to young people. These services include family planning both short-acting and long-acting methods, such as injectable, implants, and various oral contraceptives—Sexually Transmitted Infection (STI) testing and treatment, HIV/AIDS counseling and testing, management of dysmenorrhea, abortion services and other relevant services in line with the Ministry of Health (MoH) Minimum Service Package guidelines.

The BEES approach involves flying nurses based in the Youth Friendly Clinics (YFCs) who travel to the community to provide SRH and other health services, much like bees that search for flowers to gather nectar. This model has significantly improved service uptake by enhancing accessibility for all target groups and the wider community. In addition to SRH services, these flying nurses play a crucial role in addressing other public health concerns, including screening for non-communicable diseases such as hypertension and diabetes mellitus. This integrated approach to service delivery has fostered greater community acceptance and trust. Currently, each clinic serves an average of 4 to 6 clients per day, operating six days a week.

Under Phase II, the YFCs were further expanded through the construction of additional rooms to accommodate new services, thereby increasing clinic capacity and improving client flow. This expansion enabled the introduction of laboratory services, which significantly enhanced service availability and contributed to increased client numbers. With the establishment of laboratory services, YFCs are now able to provide clinical diagnosis and treatment for conditions such as urinary tract infections (UTIs), intestinal parasites, and other infectious diseases—services that were previously unavailable.

Based on the findings of a needs assessment, additional materials and medical commodities were provided to all YFCs, ensuring improved access to a wide range of SRH services in close proximity to the Youth Empowerment Centers (YECs). Flying nurses have continued to deliver family planning services directly within communities, including at the household level, enabling discreet and confidential service provision without requiring clients to travel long distances. In addition, they provide services within the YECs to further improve accessibility for young people.

This project is implemented from March 2024 to February 2026 and aims to reach 65,120 young people through the engagement of eight clinical nurses, eight laboratory technicians, and thirty-two flying nurses across eight target towns.

 

For More and Detailed Information please refer the link:

https://docs.google.com/document/d/1IfKqrpM9HF27PJcWCsDay5maoUTFRIcS/edit?usp=sharing&ouid=114900261187250094336&rtpof=true&sd=true

 

REQUIRED EXPERTISE AND QUALIFICATIONS.

The potential consulting firm to be accepted for the task has to have the following qualifications:

• Demonstrable Experience and technical knowledge on project evaluation
• The lead consultant need to have Public health Educational background (PHD, MPH) more than five-year relevant work experience.
• Demonstrable knowledge and experience working in the areas of Adolescent and Youth Sexual Reproductive health, is desirable.
• Knowledge of designing research frameworks, methodologies and tools for impact evaluation research
• Present similar work experience in the last three years (provide a sample copy of recent project evaluation reports, particularly in Ethiopia context.)
• A demonstrated high professionalism and ability to work independently and in high¬ pressure situations under tight deadlines
• High proficiency in written and spoken English is required.
• Knowledge of the local languages (Afan Oromo and Amharic) is an added advantage.
• The consulting firm has to have a legal provision, valid/renewed licenses or under acceptable valid legal cover

PAYMENT SCHEDULE

The payment will be as per DSW’s financial regulations and procedures.

SUBMISSION OF REPORT AND DATA SETS

The final evaluation report should be submitted in hardcopy and soft copy(USB) and a dashboard of all the indicator benchmarks measured through this survey will be submitted back to DSW within the stipulated time frame after due inclusion of the comments on the draft report.

CONFIDENTIALITY AND DATA OWNERSHIP

The consultant will protect the confidentiality of those participating in the survey at all stages. All data is confidential and is the property of DSW. No data or other information from this survey will be released to third parties without the written approval of DSW. The consultant will turn over all data and questionnaires to DSW and will not destroy information and material at the end of the project and after all data and original documentation has been delivered to DSW.