Terms of Reference for Consultant
Consultancy opportunity to conduct a Formative Research on the factors contributing to impairment in children and adolescents in Rwanda

Background
Disability is a major public health concern worldwide and the situation for children with disabilities is even more serious. The CRPD states that “persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others”. Some children will be born with a disabling health condition or impairment, while others may experience disability as a result of illness, injury or poor nutrition. Children with disabilities include those with health conditions such as cerebral palsy, spina bifida, muscular dystrophy, traumatic spinal cord injury, Down syndrome, and children with hearing, visual, physical, communication and intellectual impairments. A number of children have a single impairment while others may experience multiple impairments. For example, a child with cerebral palsy may have mobility, communication and intellectual impairments. The complex interaction between a health condition or impairment and environmental and personal factors means that each child’s experience of disability is different.

It is estimated that, overall, between 500 and 650 million people worldwide live with a significant impairment. According to the World Health Organization (WHO), around 10 per cent of the world’s children and young people, have a sensory, intellectual or mental health impairment. Around 80 per cent of them live in developing countries. Statistics such as these demonstrate that to be born with or acquire an impairment is far from being unusual or abnormal. Specialists, however, agree on a working approximation giving a minimum benchmark of 2.5 per cent of children aged 0-14 with self-evident moderate to severe levels of sensory, physical and intellectual impairments. An additional 8 per cent can be expected to have learning or behavioral difficulties, or both.

The Fourth Rwanda Population and Housing Census (2012 RPHC) reports revealed approximately 20% (87,900) of the population of persons with disabilities are children between the ages of five and eighteen. Many of disabling conditions in children are preventable. In Africa, one of the foremost causes of disability are infectious and communicable disease; the incidence of these diseases have been greatly reduced or eliminated in higher income countries. Other causes include war, trauma, accidents, and congenital and Non communicable diseases.

Early identification, referral and management of impairments in children has been emphasized by the National policy of persons with disabilities and its four years’ strategic plan (2021-2024) especially the strategic objective related to the strengthening of early identification, diagnostic assessment, and intervention, prioritizing children with disabilities. In response to this, different interventions are being carried out within the health sector. However, lack of evidence on disability determinants and factors contributing to the impairment in children constitute a hindrance to the good performance of the above mentioned interventions.

In partnership with RBC, NCPD and NCDA under the financial and technical support of the UNICEF, UPHLS is planning to conduct a formative Research on the factors contributing to impairment in children and adolescents in Rwanda. The research shall include the improvement plan.

It is therefore worthy to conduct the formative research on the factors contributing to impairment in children and adolescents in Rwanda in order to have the strategies to address identified factors. Once conducted, the research findings will not only inform policy makers’ planning but also provide guidance on management and/or referral of different types of major impairments in children.

To this regards, UPHLS in partnership with RBC under financial and technical support of UNICEF is recruiting a national consultant who will conduct the Formative Research on the factors contributing to impairment in children and adolescents in Rwanda.

Objectives of the consultancy
Under the direct supervision of UPHLS and guidance from Disability and inclusive health TWG (MoH/RBC, NCPD, NCDA and UNCEF), the consultant will conduct the formative research to identify the factors contributing to impairment in children and adolescents in Rwanda.

The specific objectives of the consultancy are:
Co-design the formative research and lead the implementation process of the formative research,
Develop a research protocol and present it to Rwanda National Ethic Committee for approval and research clearance,
Conduct the roll out of the research i.e pretest of the research, administration of the research tools, data collection analysis, report writing and the presentation of research findings,
Dissemination of research report with clear recommendations and plans to respond to the identified gaps,
Facilitate the publication of the research paper

Expected Results
RBC and its partners including UNICEF, NCDA, NCPD and UPHLS will use the results of the formative research to develop strategies to address the identified gaps and to design interventions for the prevention and management of impairment in children in Rwanda.

Methodology
The selected consultant will be requested to present to Disability and Inclusive health TWG members, the inception report detailing the practical work plan, proposed research methodology and data collection tools which should include: process and sampling criteria. The TWG will provide in written the feedbacks to the consultant which should be observed before the approval of the TWG.

The consultant will submit and follow up with RNEC the research protocol for presentation, approval and clearance.

Scope of work
In close consultation with the MoH/RBC, the National Council of Persons with Disabilities (NCPD), the National Childhood Development Agency (NCDA) and key stakeholders and UPHLS, develop a detailed work plan that will outline the specific activities/tasks, timelines and associated costs. Specifically, the consultant will undertake the following:

Conduct Desk review
Facilitate Inception workshop. In close consultation with UPHLS and RBC co-design the agenda and co-lead the consultative workshop with regard to the presentation of the research project to the stakeholders involved in disability as well as collecting comments and inputs to enrich the research protocol,
Design the research protocol in collaboration with UPHLS and RBC to ensure the research protocol is presented to Rwanda National Ethic Committee
Review the protocol by addressing all comments to have the final research protocol to be resubmitted at RNEC for the approval and research clearance,
Conduct formative research: Data collection, analysis and report writing
Develop the strategies/ implementation plan and related cost
Facilitate the second consultative workshop with the TWG members to present preliminary results and address inputs/comments from the group
In collaboration with RBC and UPHLS Organize the dissemination workshop for the research findings

Geographical location

The geographical location must be representative of the four Provinces and the City of Kigali. The following 10 districts have been selected based on geographical location and data shown by the Fourth Population and Housing Census, Rwanda, 2012: Nyagatare, Gatsibo and Bugesera in Eastern Province, Huye, Gisagara and Kamonyi in Southern Province, Gasanbo in the City of Kigali, Gicumbi in Northern Province and Karongi, Rubavu in Western Province.

Study population
The research will target children with disabilities and their parents. Also different relevant people/institutions will be interviewed: health care providers from health facilities, key public institutions (RBC, NCPD, NCDA, etc.), organizations of persons with disabilities (OPDs) and other key stakeholders working in disability area.

Main deliverables
Inception report showing the practical work plan, proposed research methodology and data collection tools pretested and approved by the Disability and inclusive health TWG
Submission of the research protocol to the Rwanda National Ethic Committee (RNEC) and obtaining the approval
Draft report of research findings to be presented in consultative meetings for comments and inputs,
Final report of the formative research findings with key recommendations,
Referring to the formative research findings, recommend strategies and key costed interventions to be undertaken by the government of Rwanda and its partners,
Write a scientific paper to be publicize in journals

Work relationships, supervision and stakeholder participation
UPHLS, in close consultation with MoH/ RBC NCPD, NCDA and UNICEF will be responsible for supervising the formative research. It will be directly managed by UPHLS, in close collaboration with RBC and UNICEF.

The Disability and inclusive health TWG (UPHLS, RBC, MoH, NCPD, NCDA, UNICEF, etc) will ensure technical oversight. The management of the exercise will involve validating the terms of reference for the research, liaising with the research team and other stakeholders as well as quality assurance of the tools and reports.

From UPHLS’s side, the formative research will be supervised by the Programs Director in close collaboration with RBC/ NCD Division.

Ethical Consideration/confidentiality
The study will adhere to specific Government of Rwanda research and evaluation standards (including the application for and obtaining the approval of the Rwanda National Ethics Committee).

The consultant will have to be sensitive to local beliefs, manners and customs and act with integrity and honesty in relationships with all stakeholders. Furthermore, consultants should protect the anonymity and confidentiality of the individual information.

The consultants should respect the confidentiality of the information, which is being handled during the assignment. The consultants can use documents and information provided only for the tasks related to the terms of reference of this study. Data will be stored in a secure location, kept confidential with access restricted to Data Manager/Data Analyst and principal investigators. The study data will be used only for this study, and datasets will be handed over to UPHLS, RBC/NCDs, NCPD and UNICEF at the end of the assignment.

Payment schedule
30% cent upon the signature of the contract - November 2022.
30% upon provision of the first draft report – December 2022.
40% upon provision of the final formative research – January 2023.

Skills and qualifications required
A PhD in Public Health, medical studies, Physiotherapy, Occupational Therapy, and other Rehabilitation studies, or aforementioned areas with disability studies required,
A minimum of 5 years of relevant work experience in research, research facilitation, knowledge management, evidence-informed advocacy, research impact, ethics or another related area is required.
Demonstrated background in evidence generation, communication and use on the topic of children with disabilities in health context,
Demonstrable knowledge of relevant national, international legislation and normative guidance in the area of disability and universal health coverage,
Skills in simplifying complex scientific writing for communication and advocacy messaging to general audiences
Have a minimum of 5 years of experience in research or academics
Strong research skills and experience in conducting similar works;
Excellent command of English and outstanding written skills;
Excellent analytical, interpersonal, communication and reporting skills;
Proof of former conducted assignments is a requirement;
Have a strong understanding of the Rwandan health sector strategic plan, national disability policy and strategic plan;
Working in academic field should be an added advantage.

Application process
The interested Consultants are requested to submit the following documents:
A technical proposal presenting the understanding of the issues and the research methodology, data collection tools and detailed work plan
A financial proposal
CV and academic certificates of the consultant(s)
CV and academic certificates of team that will work with consultant
Provide references from the last 5 years in similar domains
At least three recent certificates of Good Completion of similar work;
At least three referees in academic area and in working area
Proven the experiences in working with Organizations of Persons with Disabilities (OPD) will be an added value

Additional to the above mentioned documents, the consulting firm shall also submit the following documents:
Submit a valid certificate of registration/trading license of the consultancy firm issued by Rwanda Development Board (RDB);
Submit a valid certificate of Tax Clearance issued by Rwanda Revenue Authority (RRA);
Submit a valid VAT registration Certificate issued by Rwanda Revenue Authority (RRA);
Submit a valid Clearance Certificate issued by Rwanda Social Security Board (RSSB);

Company profile and CV of the team members that will be involved in the assignment including a minimum of 3 references (clients) and at least 2 sample of similar work recently done.

Selection criteria

Applications will be assessed on cost reasonableness (30%) and technical competence (70%).

Assignment Duration
This assignment is expected to be implemented within a timeframe of forty five (45) calendar days starting from the date of signing the consultancy contract. The consultant will be required to work closely with UPHLS Programs Director with guidance of RBC/Injuries and Disability Unity.

Note:

Individual or consultancy firms are encouraged to apply

The proposal that doesn’t fulfil the above mentioned requirements will be rejected automatically.

Documents will be submitted to the head office of the UPHLS KG 625 St 7, Kimihurura, Kigali, Rwanda or on infos@uphls.org not later than November 15th, 2022, at 3:00 pm Kigali local time.

Done at Kigali, 28th October 2022

KARANGWA Francois Xavier

Executive Director

UPHLS
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