Consultant (Implementation research/ Study on Village Health Committee governance)
A primary health care project was funded by Swiss Agency for Development Cooperation (SDC) starting from May 2015 in Southeast Myanmar in Kayin state with three outcomes i.e to improve access to better basic health infrastructure and services for disadvantaged people in rural communities, including conflict-affected and vulnerable populations, and that they are enabled to contribute to local health governance through enhanced individual and organisational capacities in Kawkareik township and to strengthen the collaboration between these parallel health systems of Ethnic Health Organisation and government and improve universal health coverage. This project is implemented by a Consortium viz. Partners Health Access in South Eastern Myanmar (PHASEM) in which Save the Children is a Lead Agency partnering with Christian Aid and Karen Baptist Convention (KBC). The first phase of the project was implemented from May, 2015 till December, 2018 and entered into second phase starting from January, 2019 till December, 2022. During phase one implementation, it focused on Village Health Committee formation and/or revitalisation of 165 villages in government controlled area of Kawkarik township and several empowerment activities implemented (like training, follow up meetings in the villages and respective rural health centers) with an aim of improving the governance
While working to achieve these outcomes, the role of community in achieving Universal Health Coverage is recognized as important through community engagement thus, PHASE-M facilitated formation of Village Health Committees (VHC) to strengthen local health governance. The role of VHC is to oversee the community health needs and coordinate with health care providers and health system to make health services available in their villages. The structure and function is bridging between communities and health system. VHC participate in the selection of community based volunteer health worker and support all the health events undertaken by the local health facilities in their villages. They are also responsible to mobilize the communities to participate in health promotion activities such as environmental sanitation, nutrition promotion and health education, etc. Being voluntary in nature, it is important to support the committees to be sustainable in the long run. Building capacity of the VHC members in different skills such as community mobilization, leadership and management, health awareness, etc, is also important to keep up the motivation of the members. However, the project still needs to understand what factors would support sustainability of the VHC and which would be the barriers. For this reason, an implementation research/study will be carried out to explore the motivation factors for the VHC members, for example, what made them proud to be a VHC member, their values, community perception on the role of VHCs, etc. Meanwhile, factors which demotivate them will also be identified, for example, what makes them devalue their participation, or which challenges they had to face to participate, etc. Subsequently, this study will try to co-create an implementation plan together with the VHC members, using participatory tools, which will be more sustainable and strengthen local health governance with balanced Gender dynamics in the VHCs. A monitoring and evaluation framework will be developed to constantly support the implementation. End of project evaluation will be done to assess the impact of the implementation research/study.
Audience and Use of Findings
Findings from the study will be shared with stakeholders such as State and Township Health Department, SDC, CHEB consortium members, health implementers in Kayin State and other relevant partners and organizations working on universal health coverage. The co-created implementation plan will be used by consortium members to support the village health committees to be sustainable and active in the long run. At the end of the research project, an evaluation will be done, and results will be presented to the consortium members, health departments, SDC as well as other interested donors. It is expected that this work will inform the decision-makers of health departments, donors as well as other implementing organizations to adapt this type of intervention for village health committees for community engagement to link with health system to leverage in the effort of Universal Health Coverage outcome.
SCOPE OF ROLE:
Primary purpose of the study is to understand the enhancing factors and barriers to sustainability of village health committees and what factors would strengthen local governance, then to develop a model using participatory methods which would support them. This research/study will be piloted in 10 villages in Kawkareik and Kyar In Seik Kyi, where PHASE-M is implementing and will include VHC members formed by PHASE-M in the research.
Primary Research question
- What factors motivate Village Health Committee members to actively participate in their role and in the long run?
- What barriers does village health committee have to fully participate and engage in their role?
- What model of support would sustain village health committees and strengthen their local governance?
- How does the VHC link with formal health system and communities where VHC established?
- What is the Gender dynamics in the VHC members? Is there additional opportunities or challenges for belonging to a particular gender group in a gendered context?
RO 1. To understand factors, including gender aspects, that motivate or demotivate the VHC members to fully participate in their role.
RO 2. To develop a participatory model of support for the sustainability of VHC and their local governance linking with the health system and communities.
RO 3. To test the model with pilot VHCs and modify according to learnings.
RO 4. To provide recommendations on how to support VHC to be sustainable in the long run and strengthen their local governance..
This implementation research will use Community Participatory Research Methods to have in- depth understanding of the factors influencing the behaviour of VHC members and to reflect these factors with them. Once the factors are identified with the community, an implementation plan will be developed together with the VHC members which will better support them to engage in their roles and to create ownership. A monitoring and evaluation framework will be developed to monitor the implementation and to provide timely assistance and revision. At the end of the research project, an evaluation will be carried out to assess impacts of the implementation model. Detailed research method will be discussed with the consultant and PHASE-M team and finalized upon agreement.
Reports to: Project Manager
Travel: Expected to travel to program areas in Kawkareik related to consultancy assignment.
KEY AREAS OF ACCOUNTABILITY :
The consultant will conduct implementation research (IR)/study on VHC governance by:
- Carrying out desk-review of relevant project documents, including project proposal, log-frame, and other relevant documents related to Village Health Committee Governance or Village Health Tract Committee of Myanmar.
- Design the IR protocols inclusive of methodology (community participatory research method), study tool-kits, training packages for enumerators and data entry personnel, field work plan schedule, data management plan etc.
- Train the IR field staff (supervisors, interviewers, data entry personnel) who will be recruited by the consultant.
- Consultant will lead the process of finalizing questionnaire design with technical input from Save the Children and NIMU/MoHS. However, conducting pre-test and incorporating required changes should happen during enumerator training, and this would be led by consultant.
- Develop procedures for quality control during data collection/data entry.
- Conduct field IR through the IR field team and the consultant will oversee/monitor the process of data collection and provide on the job mentoring and support.
- Perform clean data entry using appropriate software and tabulations and run analysis using a suitable software.
- Analyze and interpret the findings and share the preliminary findings of the study with Save the Children and NIMU/MoHS health team for feedback.
- Development the research implementation plan and train the project team to conduct ongoing IR until end of December 2020.
- Develop and submit the first draft of the study report with one year research implementation plan and carry out a de-brief with NIMU/MoHS and Save the Children health team through a presentation to ignite further discussion and insight that will help the consultant to finalize the write-up.
- Submit the final report to the Project Manager.
Expected deliverables (Outputs)
- Ethical Approval (if any)
- Protocol (including questionnaires and decision making tools)
- Implementation research plan
- Training including Pre-test
- Final Protocol
- Field Data Collection
- Clean and Validated Data Set
EXPERIENCE AND SKILLS:
Interested candidates will have to demonstrate capacity and experience indicating that they are qualified to provide this service. Candidates will have an in-depth knowledge and skills in research especially implementation research method. Knowledge of Kayin State context and Health Programs in Myanmar is desired.
- Knowledge and experience of Community-based Participatory Research Methods
- Experience of working on public health programs with focus on community health care in Myanmar
- Significant experience (at least 5 years) with both quantitative and qualitative research design, implementation, analysis and reporting.
- Proven conceptual, analytical and writing skills
- Proficiency of written and speokne English and Myanmar language
- Excellent planning and prioritization skill
- Understanding of Myanmar community health care system – township and below township health system covering village tract healths committee, volunteer health workers and interrelationship
- Flexible, adaptable, willing and able to travel and stay in the field with minimal basic facilities;