Terms of Reference for a Formative Research and Baseline Assessment on WASH.

PROJECT: COHERS ( Community One health Empowerment in Rwanda and Senegal).

Implementation area : Nyamagabe District- Rwanda

Background

WaterAid is an international organization that envisions a world where everyone, everywhere has access to water, sanitation, and hygiene.  Its mission is to transform the lives of the most marginalized people by improving access to safe water, sanitation, and hygiene 

WaterAid in collaboration with its partners, recently has launched the COHERS (Community One Health Empowerment in Rwanda and Senegal) project, this four-year initiative is funded by Global Affairs Canada (GAC), in a consortium led by Veterinarians Without Borders (VWB). In Rwanda, the project is being carried out in Nyamagabe district by the University of Global Health Equity and WaterAid Rwanda.

 It covers 20 villages across three sectors: Kibumbwe, Tare, and Cyanika within the district. The COHERS project aims to empower communities, with a special focus on women and girls, to enhance health outcomes by applying the One Health (OH) model to prevent, detect, and respond to prevalent zoonotic diseases. 

The project focuses on enhancing the capacity and support for community One Health Teams (OHTs) with a gender-inclusive approach in applying One Health principles. It aims to empower community members, particularly girls and women, in controlling zoonotic diseases, with a specific focus on cysticercosis/taeniasis caused by the T. solium parasite. 

 To enhance WASH practices among communities and prevent diseases linked with poor hygiene, taeniasis included, the project will focus on improving access to water, sanitation and hygiene in targeted areas through construction of the new water, sanitation facilities and promotion of good hygiene practices within the 20 communities of project interventions in Nyamagabe. 

Recognising the essential role Water, Sanitation, and Hygiene (WASH) plays in combating zoonotic diseases including proper handwashing with soap that prevents the transmission of zoonotic diseases from animals to humans, and proper WASH practices, such as use of improved latrines in communities which effectively reduce the spread of zoonotic diseases and protect public health, the COHERS project implements the Community-Based Environmental Health Promotion Program (CBEHPP) the initiative aims to empower communities to identify WASH-related challenges and proactively seek solutions through community mobilization. Part of this approach involves the establishment of Community Health Clubs (CHCs) that are supported by trained volunteers. 

Before the COHERS interventions get started there is a need to conduct an assessment to establish a starting point or benchmark while evaluating the current status of WASH practices as well as access to water, sanitation and hygiene within the 20 villages of Nyamagabe community.

It is against this background that WaterAid Rwanda is willing to hire a consultant to conduct the formative research on Water Sanitation and hygiene in the area of COHERS interventions. 

Purpose

The primary goal of the assessment is to gather detailed information on current WASH status (Water, Sanitation and Hygiene) Health facilities, other public places (slaughterhouse, markets, schools). Also, to understand the key behavioral determinants such as barrier, motives, touch points and environmental and social aspects of WASH services and behaviour in all settings. Furthermore, the assessment will explore the community understanding on Tenia Solium. The research findings will guide the implementation of COHERS project initiatives, ensuring they are tailored to address specific needs regarding WASH.

Objectives

The primary objective of this research is to understand the key behavioural determinants such as barrier, motives, touch points and environmental and social aspects of WASH services and behaviours in all settings. Furthermore, the assessment will explore the community understanding on Tenia Solium

Specifically, the formative research will respond to following;

1. Assess the current WASH Services in Health care facilities schools and schools
2. Assess the current knowledge, practices, social norms and behavioural determinants (physical, social, biological and psychological) linked to “Handwashing with soap at critical moments, use of clean toilet and hygienic management of human excreta, food hygiene, use of safe water (water treatment and proper storage), cleaning and waste management (environmental cleaning – compound and health/school facility, animal waste and exposure.
3. Assess the most promising motivators for change in behaviour and barriers and its reasons for performing key hygiene practices and prioritise adversely practiced hygiene behaviours in the project area by conducting mapping exercise. This should take into full account whatever is already known about hygiene behaviour in the area and is intended only to fill knowledge gaps.
4. Assess the extent to which hygiene promotion intervention in HCF, Schools and communities is disseminated and how it suited to the needs
5. Identify the knowledge level of community members related to Taenia Solium in COHERS project area
6. Identify the most appropriate touch points (communication channels) for WASH intervention
7. Assess the daily routine of communities, healthcare workers, schoolteachers / students and staffs and their willingness to participate in hygiene promotion activities in future. And identify potential areas for products innovation, placement of visual cues and nudges within the specific settings/environment.
8. Identify disease burden and dignity state: What are commonly reported diseases in the communities, schools and HCF setting? What are the current health problems experienced by community people, school students and health workers, staff and clients in the HCF? What are common beliefs and responses (care-seeking behaviour) associated with these problems? What are the perceived understanding about the common diseases such as diarrhoea, cholera, zoonotic diseases?

The research report will also help to tailor context-specific hygiene promotion activities to encourage desired behaviour and to determine culturally relevant strategies for effective implementation. The research will gather data on key behavioral determinants such as barrier, motives, touch points and environmental and social aspects of WASH services and behaviors in all settings. Furthermore, the assessment will explore the community understanding on Tenia Solium in COHERS WASH 20 villages of Nyamagabe district. Additionally, it will help identify key touchpoints to engage with the community during implementation, as well as explore community-based approaches to enhance intervention delivery 

The formative research and baseline assessment in HF and schools will also inform the logical framework of the project and will act as a benchmark for measuring project success and/ or challenges to achieving the desired goal. It will provide specific data as per indicators set out in the result framework against which targets, and milestones can be set/revised; and progress measured over time within each result area.

The specific objectives of the formative research are based on the key behaviours below that need to be answered. 

1. WASH current status/ behaviours in communities, HCF and schools  

• Accessibility to clean water supply and sanitation in , HCF and schools
• Presence of handwashing facilities with clean water and soap in Schools and HCF
• Handwashing at critical moments– actual behaviours
• Food hygiene – actual behaviours
• importance of WASH practices (personal hygiene, use of hygienic latrine, proper disposal liquid solid waste, safe water chain)actual practices
• Animal waste management with much focus on pig waste, environment, actual practices
• Waste management in HCF and schools

Hygiene knowledge, practices and social norms: What is the prevalent knowledge, practices (observed behaviours) and social norms (such as gender related rules or expectations) link to hygiene behaviours among target population in each setting focusing on those above-mentioned behaviours – this will be just indicative for the package design?

2. Hygiene promotion intervention in HCF, Schools and communities is disseminated and how it suited to the needs

• Functionality of community hygiene and school hygiene/ health clubs, management committee etc
• Functionality of HCF IPC/WASH/Env health committees specific to WASH activities
• Hygiene promotion interventions in HCF facilities (how they are integrated in routine PHC interventions)
• Which hygiene intervention are disseminated and who are involved (specific to each target area – e.g. HCF, school, community)?
• Any behavioral cues / nudges are in placed key locations/settings?

3. Knowledge level on Taenia Solium 

• Understanding Taenia Solium, transmission routes, signs and symptoms of cysticercosis and prevention measures.
• How is this information currently being disseminated? Where? How? By whom?

4. Current physical, social, economic, cultural, biological, environmental and attitudinal challenges/ barriers to practicing key hygiene behaviours 

• Reasons why people use appropriate WASH facilities
• Why community members practicing good/bad hygiene practices

5. Appropriate communication channels for dissemination of WASH messages  

Local communication channels that exist

• Hygiene promotion activities being delivered
• Preferred communication channels

Methodology

A) Study design

It is expected that the formative research and baseline assessment will employ a mixed method to obtain information. The assessment will adopt an observational study i.e cross-sectional study using both quantitative and qualitative methods. The methods are described as below; 

B) Data collection

The data collection tools for household, HF and School with various WASH questions will be developed by the consultant and PMEAL staff of WA and will uploaded the tool into mwater system.

C) Training of enumerators

The consultant in collaboration with WA will select and train the enumerators who will perform interview and fill out questionnaire while gathering research information. 

D) Sample size

The consultant will advise WA with an appropriate sample size for household, however all HCF and Schools will not require sample size determination.

Observation  

Observation will be used during data collection at households, public places, like slaughterhouses, schools and HF to obtain data on WASH especially while collecting data on hygiene aspects handwashing included.

Key informant interviews 

Key informant interviews will be held with all stakeholders in the program areas i,e district, sector, cell and village. The interviews will be structured and conducted face to face, and this will involve people believed to have more knowledge on the subject matter 

Focus group discussion A focus group discussion will be carried out for some selected group of people including CHCs members, women of under five years, people who provide cares for domestic animals (pigs etc)

Adequate number of groups shall be made up and the participants will be purposively selected for Focus Group Discussions to ensure participants are qualified to provide in-depth information about their experiences and how they align with objectives of the formative research (baseline assessment). 

Research tools:

This formative research study will use mostly qualitative methods with some quantitative methods. Data will be disaggregated by grade, gender, age, and disability. A range of tools will be used to collect data compromising of:

Timeframe and deliverables 

The timeframe of the assignment is 30 days (calendar) after signing the agreement. The contracted organisation/team will submit an inception report that includes final methodology and work plan with key milestones within one week of signing the contract. The inception report will be reviewed and approved by WaterAid. 

The draft report needs to be produced no later than 25 days after signing the contract. The final report should be submitted within one week of receiving feedback on the draft. There will be formal dissemination of the findings to a wider audience. 

The contracted firm/team is expected to deliver the following outputs: 

• Inception report outlining the final and detailed methodology, final data collection tools, analysis plan and detailed work plan.
• A well-written draft report aligned with the study objectives and containing detailed findings.
• A PowerPoint presentation to disseminate and validate the formative research findings with stakeholders/wider audience.
• A detailed final report not exceeding 20 pages (excluding Annexes) containing high quality executive summary (concise and well-articulated), interesting findings, recommendations, and synthesis of key issues.
• Hardcopy (01) and Softcopy of the final report including all datasets and analysis framework (raw and cleaned database).

All reports must be presented to WaterAid Rwanda for quality assurance, and comments to be accommodated accordingly. 

Expected competency of consultant(s) 

Interested consultants/consulting/research firm(s) is expected to have the following competencies and experience: 

• Expertise in conducting WASH and hygiene behaviour change assessment and mix-method studies.
• Experience in conducting large survey using online based data collection tools (mWater platform will be preferred).
• Expertise in conducting studies (Baseline, Midline, Endline, Situation Analysis, and other thematic studies) in WASH sector or a similar context
• Sound skill on quantitative (Advanced Excel, SPSS, STATA) data analysis with high skills on data visualization and presentation techniques.
• Experiences in using the qualitative study methods and analyzing the qualitative data.
• Competency in Data Collection Tool through using mWater platform.
• Competent team for data collection and analysis
• Competency in writing good quality reports in English

Application 

Potential qualified individual consultants or companies are encouraged to submit both technical and financial proposals including: 

Technical proposal: including a plan of execution of the assignment above mentioned, clear description of proposed methodologies, schedule of work, and the names and CVs of consultants and their roles. Capacity statement with a description of previous experience and demonstrated ability to perform this assignment and three referees. All application must be submitted before 16^th August 2024 COB. 

Technical and financial proposals will be submitted to WARwanda@wateraid.org.