South Sudan: International Consultancy: Behavioural Study on Determinants of Use/ Non-use of Family Planning

Background:

Family planning uptake is low in South Sudan. Contraceptive prevalence rate is 4.5% for all methods and 1.7% for modern methods in SHHS 2010, but estimated at 3.3% in 2016 for all women and 5.5% for women in union by FP2020 FTEP. The FP2020 FTEP for 2016 estimated 31.5 per cent of women with an unmet need for a modern method of contraception and 13.7 per cent of women whose demand is satisfied with a modern method of contraception. Information on family planning use levels, discontinuation, and on levels of facility based family planning use, method mix, etc. remain scanty.

It is believed that socio-cultural factors as one of many demand side factors play significant influence on use and non-use of family planning in South Sudan. There are also some supply side factors that affect and sustained use of family planning. There is therefore need for rigorous study to determine how it works to cause the influence. In this way, appropriate strategies can be designed to address the determinants of the use in ways that respond to how the factors interact.

The consultancy aims to carry out a national study on determinants of use and non-use of contraceptives in South Sudan. More importantly, the study is planned to use qualitative method to dig further into the factors that determine use and those that hinder use, with a deeper insight into meanings and explanations beyond the normal factors such as side effects, spousal approvals, religious beliefs, etc. It is intended to understand the reasons behind these and other concerns in family planning use from individual, family, community and institutional perspectives and how some people, despite these concerns on family planning use, are still motivated and continue to use family planning.

The result of the study is planned to guide policy-making, programming, and monitoring and evaluation of government policies and programmes on family planning at national and sub-national levels. Humanitarian access permitting, it is preferred that the data for the behavior study on family planning use or non-use show any subtle differences to aid evidence-based planning at national and lower levels. It will also be used in designing a programme for social and behavior change communication that could be designed to address individual and contextual positive and negative antecedent factors to family planning/contraceptive use.

Scope of work:

The main objective of the behavior study on use and non-use of family planning in South Sudan is to provide information on family planning status in South Sudan and factors that influence its use/ non-use.

The specific objectives are:

1. To explore the factors and how they interact at the individual, couple &family levels and in service accessibility, socio-cultural and policy environment factors influencing family planning/contraceptive use in South Sudan,

2. To explore the decision making process on family planning/contraceptive use at the individual, couple and family and health service delivery sites

3. To explore the knowledge, perception, beliefs and decision making on long acting family planning method

4. To provide policy options for effective communication of family planning methods at the individual, family, community and health service delivery points.

A team of one international consultant, supported by a national consultant, will implement the study. The two consultants will be recruited and directly supervised by UNFPA. The international consultant will have the lead responsibility to manage the whole research process.

The existing multi-sectoral Reproductive Health Coordination Forum will be constituted to provide technical backstopping, including: input into study design, development of study tools/questionnaires, training and report writing. For purpose of ownership, the Reproductive Health Coordination Forum will also review and endorse the consultant’s work before final approval by MOH and UNFPA.

The consultants will work in a participatory manner under the leadership of the Ministry of Health and UNFPA Representative and in close collaboration with line Ministries to collect, process, analyze and produce succinct reports.

Specifically, the consultants are expected to:

· Review literature and prepare background reports on family planning in South Sudan in general

· Select, in consultation with MOH and stakeholders, the states for sub-national data collection, taking into account geography, socio-cultural, ethnicity, and other factors influencing family planning use or non-use.

· Prepare appropriate study design, methods and data collection tools.

· Plan for and secure appropriate logistics and other support needed for proper conduct of the study

· Recruit and train research assistants and other needed technical and support staff for proper conduct of the study

· Mobilize national and local level support for conduct of the study

· Liaise and consult with MOH, UNFPA, RH Coordination Forum and RHCS/ Family Planning Technical Working Group for technical and logistical support for smooth conduct of the study

· Conduct data analysis in addressing the research objectives.

· Based on data analysis, prepare draft study report for review by RH Coordination Forum and selected peer reviewers, and integrate comments from these into the final study report.

· Conduct national level validation workshop on study findings and prepare a report of the workshop, while integrating relevant issues from the workshop into the study report.

· Present the final draft report to MOH and UNFPA for approval in accordance with government protocol and procedures;

· Prepare concise dissemination materials, such as an executive summary/ brief of the study;

· Work within tight deadline to prepare and submit on time, all the deliverables for this assignment, ensuring the final report is copyedited, formatted, and ready to be printed;

· Other related tasks to the scope of work as determined by the Minister of Health and/ or the UNFPA Representative.

The consultants will propose appropriate qualitative, including ethnographic methods that allow for in-depth inquiry (digging behind the existing data and trends on FP use) into reasons behind use and non-use of FP in South Sudan. Conducting qualitative study in areas which are currently known to show high levels, unchanging levels and low levels of FP use may offer some insight into the contextual factors driving family planning use or non-use in general in these areas.

In the choice of study methods, consideration should also be made of services providers’ knowledge, attitude and practices towards provision of family planning in South Sudan. Further, the consultant should pay specific attention to getting a deeper understanding of the needs, preferences and perspectives of specific segments of the population regarding existing and future family planning methods.

Populations of interest might include, among others:

· Women who want no more children

· Adolescents, ages 15-19

· Nulliparous women

· Current users of modern contraception

· Current non-users of modern contraception

· Women with heath concerns; women who don’t use contraception due to side effects

· Women seeking to prevent both pregnancy and STI/HIV infection

· Married men

· Unmarried men

· Family planning service providers, RHCS focal points, logistics managers, health planners, managers and administrators

Examples of specific issues to consider (not exhaustive) include:

· Product-related barriers and/or facilitators experienced by specific groups of women or adolescents in accessing or using existing contraceptive methods and services;

· Product-related reasons for non-use (non-adoption or discontinuation) of current methods among specific populations;

· Perceptions of menstrual effects of methods, including irregular bleeding and amenorrhea;

· Prevailing norms of contraceptive preferences and use within specific populations or geographies;

· Women’s motivations to use family planning methods; motivations to select specific methods, including modern methods, natural family planning or other traditional methods;

· Interest in using a permanent method of contraception among women and/or couples who have completed their desired family size;

· Desired attributes of contraceptive methods, among specific groups of users or non-users of contraceptives, including route of administration, duration of action, service delivery point, desired non-contraceptive benefits, or other features; the potential of contraceptive attributes to influence uptake and continued use of any given method;

· Men’s needs and perceptions of existing or future contraceptive methods;

· Men’s willingness to use and/ or support partners in using a family planning method and desired attributes of contraceptive methods, including route of administration, duration of action, service delivery point, or other features;

· Provider perceptions of the range of contraceptive methods currently available; provider comfort with specific methods and attitudes toward administering contraceptive methods to different groups of women or to adolescents;

· Supply side constraints such as budgets, training & skills, availability of products, etc.;

· Socio-cultural values, beliefs and practices;

· Customary laws, policies and practices.

Duration and working schedule:

The assignment is expected to take a period of 5 months from design to production of the final report, not exceeding 60 working days per consultant. Part of the work will be done by the consultants in their place of residence as well as visit to Juba and selected states during the survey and data collection. The successful candidate is expected to start immediately in July 2017.

Place where services are to be delivered:

Juba, with visits to selected state level destinations.

Delivery dates and how work will be delivered:

Starting early July, 2017 The following are the deliverables to be approved by UNFPA:

1) Inception report detailing background, literature review, study design and methodology, a complete set of study tools for qualitative elements.

2) A validated Family Planning Behavior Study Report for South Sudan that integrates comments from peer reviewers to be identified and comments from participants at a validation workshop

3) A Validation Workshop Report on Family Planning Behavior Study

4) Dissemination plan, copies of PowerPoint presentations, policy briefs and factsheets.

Monitoring and progress control and supervisory arrangements:

The consultant is expected to submit bi-weekly progress reports/ briefs on tasks and assignments. A final Report and knowledge transfer note is expected at the end of the assignment.

Under the overall direction and strategic guidance of the Country Representative, and the supervision of the Deputy Country Representative, the consultant will work closely with RHCH Specialist and RH Directorate at MOH to deliver on the assignment.

Expected travel:

Tentative arrival date to Juba mid/end July, 2017.

Tentative departure date from Juba mid/end December, 2017.

Required expertise, qualifications and competencies, including language requirements:

The assignment is looking for a team of two consultants (one international and one national) who may apply jointly or individually. For those who make individual applications or one of the joint applications should be willing to work with another consultant, if your and the other consultant’s strengths are found to be best suitable match to undertake the assignment. This may mean another person from the one you could have jointly applied with for the assignment.

The consultants should have strength in quantitative and qualitative studies and with substantial experience in planning, implementing and writing reports of national level or large scale demographic, socio-economic and health surveys and in qualitative or anthropological studies. Strong background in publication of survey reports and related studies are preferred.

The international consultant needs to have to following additional qualifications and experience:

• Masters degree (PhD an asset) in the area of demography and population studies, statistics, public health, social science and related research oriented disciplines

• at least ten years of experience

• fluency in oral and written English.

Previous in-depth knowledge and understanding of issues of sexual reproductive health and family planning inequities in South Sudan or similar context is desirable. Other desired skills include: good diplomatic skills and experience interacting with host country government agencies including development partners, and civil society organizations; and familiarity with information technology, including proficiency in word processing, spreadsheets, and presentation software.

• Applicants should submit their applications through email. Please send your cover letter and CV/P11 (www.unfpa.org/resources/p11-un-personal-history-form) and other supporting documents to SSCO.vacancies@unfpa.org
• All applications should be cleared marked with Subject Line “Behavioural Study on Determinants of Use/ Non-use of Family Planning (International Post)”.
• Deadline for applications: 10 July 2017, 11:59pm South Sudan time.
• We will only be able to respond to those applicants in whom the Country Office has further interest.
• UNFPA is committed to maintain balanced gender distribution of the positions and therefore encourages women to apply.
• UNFPA does not solicit or screen for information in respect of HIV or AIDS and does not discriminate on the basis of HIV/AIDS status.
• UNFPA offers an attractive compensation package commensurate with experience.
• IMPORTANT: There is NO application processing or other fees at any stage of UNFPA application processes.