Health Systems Strengthening Specialist- Performance Evaluation of Police and Prison Activity

PEPFAR funds the USAID Police and Prisons Activity to support implementing comprehensive HIV and TB prevention, care, and treatment services in 64 Police and Prisons health facilities (HFs) in Tanzania mainland and Zanzibar. The Activity is implemented by Tanzanian Health Promotion Support (THPS) through USAID Police and Prisons Activity in collaboration with Ministry of Home Affairs (MoHA) through the Tanzania Police Medical Unit (PMU) and Tanzania Prisons Health and Nutrition Unit (PHNU); both units have the mandate to oversee health matters on the respective forces.

USAID’s Police and Prisons Activity goal is to improve Tanzanians’ health status through appropriate interventions and sustainable delivery of health services to Police and Prisons staff, their families, and surrounding communities.

The Activity intends to achieve this goal through three objectives and intermediate results.

Objective 1: Improved access to HIV & TB Prevention, Care and Treatment Services

Intermediate Results:

Improved HIV and TB case detection
Increased numbers on appropriate treatment regimens
Increased numbers receiving prevention-related interventions

Objective 2: Improved Quality of HIV and TB Prevention, Care and Treatment Services

Intermediate Results:

Improved efficiency of services
Increased linkage rates (closed referrals)
Improved retention rates

Objective 3: Strengthened Systems for Delivering Quality HIV and TB Prevention, Care and Treatment Services

Intermediate Results:

Improved capacity and skills of health care workers
Strengthened continuity of care between prisons and community health systems

Statement of Purpose:

The intent of this evaluation is to conduct a performance evaluation of the Police and Prisons activity, in order to generate information and learnings that the USAID/Tanzania Health Office needs in order to inform future work in uniformed forces health facilities.

Uses and Users of Evaluation:

The primary users of this evaluation will be USAID Tanzania Health Office staff, as it will be directly used in new activity design. However, the evaluation may also be shared with Government of Tanzania officials and other development partners who work in the HIV and TB fields, in order to share lessons learned and better improve the overall HIV and TB programs in the country.

Key Stakeholders:

1. USAID Tanzania HIV/TB Team
2. Ministry of Health (MoH)
3. Ministry of Home Affairs (MoHA)
4. President’s Office, Regional Administration and Local Government (PO-RALG)
5. Local Government Authorities (LGAs) in areas of implementation
6. Health Facilities and/or Healthcare workers
7. HIV and TB implementing partners
8. Development partners that also support HIV and TB work

Preliminary Evaluation Questions:

1. To what extent are the interventions implemented by the Police and Prisons activity relevant to the HIV and TB needs of Tanzania and to USAID’s HIV and TB policies? Has the activity facilitated uptake of HIV and TB services within Police and prison communities, and if so, are there differences in the extent of that uptake between supported and non-supported facilities?
2. To what extent has the Police and Prison activity been effective at improving HIV and TB outcomes for prisoners and for the general population? And in what ways do TB treatment outcomes differ across both regions and various populations (prisoners versus general population, age groups) in terms of treatment completion, treatment success, and mortality?
3. In what ways did the Police and Prisons activity engage the Tanzania PMU and PHNU on activity coordination and implementation to facilitate ownership, partnership and sustainability? To what extent will the outcomes of this activity be sustained once it ends, and what more can be done during the remaining life of the activity to improve that sustainability?
4. What are the most important learnings from the Police and Prisons activity that can be used to inform future HIV and TB programming? In particular,
5. To what extent is there a continued need for a standalone activity for this work, or could it be integrated into other clinical activities? Are there differences between police and prison facilities that should be taken into consideration when making this determination?

Position Description:

SI seeks a Health Systems Strengthening Specialist to support T-MELA with the Performance Evaluation of Police and Prison Activity.

The Health Systems Strengthening Specialist will bring expertise in enhancing the efficiency and sustainability of health services, including financial management, supply chains, and governance within health facilities. Familiar with the Tanzanian health system and the role of faith-based organizations, they assess how well the activities have integrated health service delivery with systemic strengthening efforts, offering insights into the sustainability and potential scalability of these interventions.

This is a consulting position with an estimated performance period of August 2024– February 2024. The estimated level of effort (LOE) for the Health Systems Strengthening Specialist will be 60 days of LOE.

Responsibilities:

· Support development of evaluation design and implement evaluation design for health system strengthening activities, focusing on HIV and TB prevention, care, and treatment services within police and prison health facilities.

· Conduct desk reviews of relevant USAID and Government of Tanzania policies and strategies.

· Perform key informant interviews with national and regional officials, implementing partners, and healthcare workers.

· Facilitate focus group discussions and administer questionnaires to healthcare workers at the facility level.

· Analyze activity monitoring and performance data, including data from government systems such as DHIS2, CTC2, and eTL.

· Compile and synthesize findings into a comprehensive final evaluation report addressing all evaluation questions.

· Provide detailed recommendations for future HIV and TB programming in uniformed services health facilities and for how to facilitate communication and collaboration between stakeholders to ensure the sustainability of health interventions.

· Support the evaluation team to prepare and present key findings and recommendations to the USAID Health Office and other stakeholders.

· During data collection, coordinate with key stakeholders, including the USAID Tanzania HIV/TB team, Ministry of Health, Ministry of Home Affairs, local government authorities, health facilities, and development partners.

· Ensure the evaluation process adheres to the highest standards of quality and rigor.

· Implement measures to ensure data accuracy and reliability.

Deliverables:

With support from USAID/T-MELA and team members, the Team Lead will be expected to take overall responsibility for the production and management of the following:

1. Final Evaluation Design: A detailed, full assessment design and work plan following an initial consultation with USAID will include chosen methodologies and data collection tools.

2. Design Presentation Meeting/In brief: A PowerPoint/Google Slides presentation summarizing the methodological approach to be used to execute the assessment for USAID/T-MELA and key partners prior to the launch of data collection.

3. Findings Conclusions and Recommendations (FCR) Matrix: An analysis tool through which data is triangulated and findings, conclusions, and recommendations specific to each assessment question are produced. Two FCR matrixes are expected, a preliminary document after the first full week of data collection, and a final matrix at the end of the data analysis period.

4. Enhanced Out-brief/ co-creation workshop with USAID and IP (were requested) PPT: The team will present the key findings to key USAID/Tanzania stakeholders through a PowerPoint/Google Slides presentation and co-creation workshop. The TL is expected to update this PowerPoint after the final report.

5. Draft Evaluation Reports: A draft regional reports with fully developed findings, conclusions, and recommendations, no longer than 30 pages excluding annexes, will be submitted to the T-MELA COP who will submit to the USAID COR for T-MELA activity. The format will include an executive summary, table of contents, methodology, findings, and recommendations. USAID/T-MELA and key local stakeholders will provide comments on the draft report.

6. Final Reports: The team will submit a final report that incorporates responses to USAID’s/partner’s comments and suggestions. The report will be submitted electronically in English. The report will be disseminated within USAID and key stakeholders.

7. Weekly progress report: Provide weekly progress report to USAID-TMELA and SI in the agreed format.

Qualifications and Skills:

The Health Systems Strengthening Specialist must be Tanzanian and have/holds:

· At least 8 years of senior-level experience working on evaluation/assessment is desirable.

· Master’s degree in health administration, Public Health, or a related field focusing on health systems.

· Proven experience in evaluating health systems strengthening projects.

· Knowledge of the Tanzanian healthcare system and challenges to health facility sustainability.

· Extensive experience designing and conducting evaluations, including quantitative and qualitative research methods.

· Strong understanding of health data systems in Tanzania, including DHIS2.

· Experience in the designing of instruments for data collection including quantitative questionnaires, qualitative tools such as KIIs and Focus Groups using diverse technology.

· Experience working with international donors, especially USAID.

· Preferably, the applicant will possess experience conducting evaluations in East Africa, Tanzania in particular.

The selection and interview will be performed on a rolling basis, and interested candidates are encouraged to apply as soon as possible.

To apply, please merge both your CV and a cover letter into one PDF file and submit it through the online portal.

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Only selected candidates will be contacted for an interview. Please, no phone calls.