Assessment of Government and Camp level Facilities' Sexual Reproductive Health (SRH) Services
Objective:
This assessment aims to analyze the development of Sexual and Reproductive Health (SRH) services at 20 government facilities in Cox’s Bazar supported by the United Nations Population Fund (UNFPA) before and subsequent to UNFPA interventions. The objective is to determine the preparedness of these facilities to deliver SRH services and to assess the potential impacts of a withdrawal of UNFPA support.
Location of the Assessment:
The assessment will be conducted at 20 facilities in Cox’s Bazar supported by the UNFPA. These include 11 government facilities, which encompass 2 Upazila health complexes, 3 sub-centres, 6 Union Health and Family Welfare Centres (UHFWCs), and 9 camp-level facilities, which include 1 field–level hospital, 7 Primary Health Centers, which encompass Noyapara and Kutupalong RC, and 1 health post within the camps.
Scope:
- Readiness Assessment: This assessment will focus on the preparedness of these facilities to deliver sexual and Reproductive Health (SRH) services. Key evaluation aspects could include general service availability, service-specific readiness, health workforce, health information system, access to essential medicine, and health governance and financing mechanisms.
- Baseline Service Evaluation: An assessment will be conducted to evaluate the state of SRH services at facilities before UNFPA’s intervention, emphasizing their availability, accessibility, quality, and utilization.
- Impact Analysis: Following UNFPA’s support, this analysis will determine the changes or enhancements in SRH services. It will involve a comparative assessment of infrastructure, service offerings, waiting times, operational hours, staffing levels and expertise, collaboration with other stakeholders, and community engagement, against the baseline data to highlight improvements.
Indicators:
1. Readiness Assessment:
- General Service Availability: Presence of essential infrastructure and operational status of facilities.
- Service-Specific Readiness: Availability of Minimum Essential SRH services as defined by relevant health standards.
- Health Workforce: Number of trained staff available to deliver SRH services, segregated by gov and NGO
- Health Information Systems: Existence and functionality of health information systems.
- Access to Essential Medicines: Availability of necessary medicines and medical equipment.
- Governance and Financing: Presence of supportive policies for SRH services and percentage of the facility’s budget allocated to SRH services.
2. Baseline Service Evaluation:
- Service Accessibility: Availability of transportation options to access facilities and proportion of females of reproductive age in the catchment areas.
- Service Availability: Hours of operation and number of staff before UNFPA intervention.
- Service Quality: Baseline client satisfaction with services and provider behavior.
- Service Utilization: Initial numbers of clients using SRH services at outpatient and inpatient departments.
3. Impact Analysis:
- Changes in Infrastructure and Service Offerings: Comparison of the physical and service capacity pre-and post-intervention.
- Staffing Improvements: Comparison of staffing levels and expertise before and after UNFPA support.
- Enhanced Service Quality and Utilization: Changes in client satisfaction, SRH service coverage, and average waiting times.
- Community and Stakeholder Engagement: Assessment of community outreach impact and collaborations with other stakeholders.
Methodology:
- Desk Review: Review existing documents, reports, and datasets concerning SRH services before and after the UNFPA interventions.
- Stakeholder Consultations: Engage in interviews and discussions with stakeholders such as government personnel, UNFPA representatives, healthcare providers, community leaders, and service users.
- Facility Assessments: Inspect and evaluate the infrastructure, service delivery, staff capabilities, available equipment, and client satisfaction at the facilities.
- Data Analysis: Synthesize both qualitative and quantitative data to discern patterns, obstacles, and potentials within the SRH services provided.
Expected Outputs:
- Comprehensive Assessment Report: Produce a thorough report detailing findings, conclusions, and actionable recommendations, focusing on the development of SRH services and the influence of UNFPA’s involvement.
- Policy Brief: Create a succinct briefing for policymakers that encapsulates critical insights and advice, emphasizing the necessity for ongoing support of SRH services.
Funding:
The United Nations Population Fund (UNFPA) will fund the assessment to strengthen SRH services and promote reproductive rights globally.
Independence of Consultant:
The assessment will be conducted by an independent consultant, ensuring impartiality and objectivity in the evaluation process.
The consultant shall not have any vested interests in the assessment's outcomes, maintaining integrity throughout the evaluation.
Confidentiality and Data Protection:
All data collected during the assessment shall be treated with utmost confidentiality.
Personal and sensitive information of individuals accessing SRH services will be protected by relevant data protection regulations.
Ethical Considerations:
The assessment will adhere to ethical guidelines, respecting the rights and dignity of individuals accessing SRH services.
Informed consent will be obtained from participants involved in interviews, surveys, or any data collection activities.
Transparency and Accountability:
The assessment process, including methodologies, findings, and recommendations, will be transparent and accessible to relevant stakeholders.
The final report will accurately reflect the assessment findings, without bias or manipulation of data.
Reporting and Dissemination:
A thorough report will be compiled, outlining the assessment's findings, conclusions, and recommendations, which will then be submitted to UNFPA for review.
Review and Feedback Mechanisms:
UNFPA will review and provide feedback on the draft assessment report before finalization. Feedback received needs to be duly considered and incorporated into the final report.
Timeline:
The assessment is expected to be conducted over 45 days, with the final report and outputs delivered by 25 June 2024.
Conclusion:
This assessment will provide valuable insights into the effectiveness of UNFPA's support in enhancing SRH services at government facilities and inform future strategies for sustaining and scaling up these services. By understanding the challenges and opportunities, policymakers and stakeholders can work together to ensure the continuity and improvement of SRH services, ultimately contributing to the health and well-being of communities.
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