Consultant for Family Planning Research

Hiring Office: UNFPA ESARO (East and Southern Africa Regional Office)

Purpose & Background

UNFPA seeks to conduct a research to understand why modern contraceptive use is stagnating in some countries in East and Southern Africa and how to move beyond the stagnation point. Identifying women with unmet need for family planning, and their reasons for non-use, will help design more effective programmes that better meet the contraception needs of all women in the region and achieve universal health coverage.

This research is part of the PREMDESA programme, managed by UNFPA and funded by UKaid. It aims to contribute to the achievement of universal access to sexual and reproductive health, realize reproductive rights, and reduce maternal mortality in East and Southern Africa. This research will generate evidence to inform design, planning, scale up and delivery of quality FP services for women and youth. It will directly contribute to Sustainable Development Goal 3.

While the percentage of women using modern contraception (mCPR) has increased in most countries of the region since 2000, the data show three distinct groups of countries. The first group has had rapid and significant rises in mCPR until 2005/2010 and shows stagnation at relatively high levels. In the second group, the upward trend is regular and the latest mCPR is above 50. In the third group, the progression has been slower, trends are still going up but mCPR is still low. A few countries are outliers (incl. one has stagnated before rising again after years of stagnation).

There is a need to compare user experience within and between countries with diverse trends to better understand factors determining modern contraceptive demand and use, and allow countries to learn from each other. It is anticipated that the lessons learnt from in-depth analysis in group 1 and group 2 countries (mCPR stagnating and countries with high CPR levels) will not only benefit FP programmes in those countries, but also those in the countries of group 3 (mCPR progressing in a slower manner): Identifying the common factors that hamper some sub-groups of women from accessing modern contraceptives in countries where mCPR stagnates at relatively high levels and identifying factors that enabled some countries not to stagnate will help the countries whose progress is slower to develop programmes to anticipate a possible stagnation at a later stage, so that they follow an upward trend. Identifying factors that enabled countries to rise again after stagnation will help those countries that stagnate to overcome stagnation.

Research exists to understand the factors that prevent some women from using modern contraceptives, but often these data are limited to a small geographical area, are historically out of date, and/or conducted within the same countries. Most studies do not take into consideration the latest DHS (after 2012) while much has been invested in FP in the last years. They often do not consider various sub-groups of women, failing to assess which women exactly are left behind and the analysis of women’s motivations, service experience and interests is often shallow. They often identify generic barriers that translate into general recommendations.

Recent family planning research indicates the following research needs and gaps

• Better understanding of barriers to contraceptive use faced by unmarried sexually active women (Sedgh G. and Hussain R., 2014, Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries, The Population Council) – whose unmet needs are greater than among married women (DHS comparative report, 2014);

• Identification of reasons for non-use, beyond what is reported in the DHS: In DHS, women give one reason for non-use while they might face multiple barriers and might give the reason they are the most comfortable with (Sedgh, 2014);

• Reasons for use of traditional methods contraception, even when modern methods are available;

• Reasons for discontinuation: Many women who have unmet need have practiced contraception in the past – it will be interesting to understand their reasons for discontinuation.

• Little analysis to integrate the in-depth data on women’s experience with larger trends in CPR, demand satisfied by modern method and TFR, to understand why is CPR stagnating in some countries while TFR continues to go down.

Responding to these questions will help to better target interventions to women in the greatest need of quality FP services where, hence address equity issues in the region. It will help South-South exchanges on family planning. The qualitative research will also be useful to identify and validate the indicators that must be monitored to better understand family planning needs, interests and utilisation of services. In addition, as contraceptive uptake is one of the key components to realizing the demographic dividend in Africa, this information will be crucial to develop relevant interventions to reaching this goal, together with SGD 3.

Methodology and tasks

1.     Task 1: Conduct a review of the literature (published articles and grey literature) and develop a DHS analysis protocol specifying which indicators will be looked at and why;

2.     Task 2: Conduct analysis of DHS data

·         Broad data analysis on trends in ESA 21 countries: CPR, mCPR, traditional CPR, unmet need, demand for family planning satisfied with modern methods, rates of counselling on alternate FP methods and potential side-effects, rates of FP discontinuation at defined intervals, reasons for non-use of FP; TFR. Data will be disaggregated by age, wealth, location, marital status and other covariates of interest.

·         Based on the comparative analysis of the countries in the region, identify two countries where mCPR is stagnating; and potentially 1 country where use if highly inequitable at sub-national level; conduct a detailed analysis on their DHS to identify sub-groups of women for whom mCPR is stagnating and why. Trends to be analysed on several potential determinants at individual and community levels, including but are not limited to: age, marital status, parity, education, fertility intentions and preferences; contact of non-user for family planning; prevailing quality of services; prevailing age of first birth; prevailing education norms, and community access to abortion. Identify one country that can be considered as a “good case scenario”, because it has high mCPR and interesting lessons can be learnt

3.     Task 3: Based on the results of the DHS analysis, develop specific research questions and target specific sub-groups of women and geographical areas for qualitative in-depth research,

4.     Task 4: Develop a qualitative research protocol (Incl. research tools, key respondents and data analysis matrix);

5.     Task 5: In collaboration with UNFPA country offices, recruit three national consultants to support in-depth research in the three countries;

6.     Task 6: Conduct in-depth qualitative study in 3 countries and write report, with inputs from national consultant;

7.     Task7: Develop of draft synthesis report, including operational recommendations; discuss of preliminary study results at ESARO office and finalise the report

8.     Task 8: Presentation of final report

 

Duration and working schedule

·         Short inception report outlining detailed workplan and steps (1 working day, by 25 August)

·         Tasks 1, 2, 3: Literature review and DHS data analysis, meeting at UNFPA ESARO to review of the DHS analysis results, discussion on the qualitative research protocol (22 working days, by 25 September 2016)

·         Tasks 3, 4, 5: Finalisation of the qualitative research protocol; management of the ethics approval process; management of the recruitment of the national consultants, under the supervision of UNFPA regional office and relevant country offices (7 working days, by 17 October)

·         Task 6: Conduct qualitative research in three countries, in collaboration with national consultant (21 working days per country=63 days; first country visit: By December 10^th; first country Report: By Dec 30^th)

·         Task 7: Preparation of synthesis report and presentation of preliminary findings at ESARO office (9 working days, date to be defined);

·         Task 8: Incorporation of comments and finalization of report (3 working days, final reports due on March 1^st 2017)

 

Deliverables

·         Short inception report

·         Tasks 1, 2, 3: Literature review report; DHS analysis protocol; DHS analysis on 21 countries (report + country briefs for research uptake and advocacy)

·         Tasks 3, 4: Three qualitative research protocols for submission to  national ethics committees

·         Task 5: Three national consultants recruited

·         Task 6: Three country reports

·         Task 7: Draft Synthesis report, including recommendations; power-point; research brief for research uptake

·         Task 8: Final report.

 

Place where services are to be delivered

Home-based / 3 ESA countries / UNFPA Regional Office for East and Southern Africa, The Sunninghill Place, 9 Simba Road, Sunninghill, Johannesburg, South Africa.

 

Monitoring and progress control, including reporting requirements, periodicity format and deadline

Email and/or calls with the Research and Evidence Specialist, as needed - at least weekly during working periods - to discuss progress and findings, share working drafts and reports and take decisions on the way forward. 

 

Supervisory arrangements

The consultant will work under the direct supervision of the ESARO Evidence and Research Specialist, with technical support from the RHCS/CCP Technical Specialist.

 

Expected travel

To the three countries for in-depth study and to Jhb for briefing/debriefing meetings. UNFPA will cover the travel expenses to the three countries in accordance with its travel policies. 

 

Required expertise, qualifications and competencies, including language requirements

• Masters degree or PhD in public health or similar
• At least 10 years of professional experience in research (qualitative and quantitative)
• Excellent analysis, synthesis and writing skills – as evidenced by articles published in journals
• Working experience with UNFPA and/or in family planning research
• Proven experience in conducting multi-country studies
• Established proven professional network in ESA countries

How to apply?

Applicants are asked to submit the following to chirowamhangu@unfpa.org, before Wednesday 27 July, 8am South African time:

• Letter of motivation outlining suitability for this work, a brief description of how the candidate would intend to conduct it, any comment on the ToRs, name and contact of three references, daily consultancy rate (the maximum is P5-level) and detailed availability over the working period (maximum 3 pages)
• A recent CV
• Samples of research produced related to the Terms of reference