You are here

Individual Consultant: Rapid assessment of the COVID-19 pandemic on continuity, access and utilization of essential sexual and reproductive health services within the public health facilities

Scope of work

Botswana recorded the first case of the COVID-19 virus on March 31 2020 resulting in prompt measures to contain the spread of the disease within the country including extreme social distancing, closure of ports of entry and declaration of State of Public Emergency. As of July 23 2021, Botswana has recorded 102,124 local COVID-19 cases and a total of 1485 deaths translating to a case fatality ratio (CFR) of 1.45%. The pandemic is compounding the existing health system and response challenges. Keeping the health system functioning, maintaining essential health services whilst also responding to the COVID-19 situation is a difficult balancing act particularly as human and financial resources are diverted from various health programs to respond to the infectious disease outbreak. Service disruptions may result from stockouts of essential commodities, repurposing of healthcare workers at all levels and temporary closure of health facilities. Accessibility of services can also be affected by specific mitigations such as lockdowns, curfew and the effects these have on access to transportation and other household needs. Those needing health services may delay or avoid seeking care at facilities from fear of infection or lack of trust in the health system.As part of the COVID-19 response efforts, the MOHW was prompt in identifying essential health services to be maintained in the midst of the pandemic and these included sexual and reproductive health and rights services including maternal health and newborn, family planning and HIV/AIDS services. Notwithstanding this, anecdotal evidence suggests that due to measures to control the pandemic such as movement restrictions, access to SRHR services may have been impeded. Further, frequent stock outs of reproductive health commodities essential SRH including family planning have been reported during the course of 2020, with the country struggling to meet recommended stock levels for family planning commodities during periods of crises. The inevitable rationalization and equitable distribution of healthcare workers in response to COVID-19 in a country already facing shortage of skilled health workers will very likely impact the continuity of essential health services, including SRH, HIV and GBV services. The WHO guidance on monitoring effects of COVID-19 on essential services recommends that health managers at national level should review indicators at least every quarter with an aim to answer specific questions about the progress of health programmes. For effective programming and response planning, it becomes imperative that the extent to which availability, accessibility and utilization of essential SRHR services have been affected by the COVID-19 pandemic be established. Review of key SRH indicators will help to provide an overview of SRH services continuity and help to detect problems and critical areas of intervention. It is against this background that the MOHW with support from UNFPA will conduct a rapid assessment on continuity of SRH services in 2020 with 2019 as the comparator year. The assessment will focus on four key areas namely; a) coordination, b) innovation, c) supply chain management during covid era and d) performance of SRH key indicators during covid.

Objectives and Scope of the Consultancy

This assessment aims to assess the extent to which availability, accessibility and utilization of essential SRHR services have been affected by the COVID-19 and to understand the drivers of changes in the values of the indicators to ultimately inform planning and decision-making. Key SRHR performance indicators will be analysed to assess changes in access to and delivery of essential health services within the context of the COVID-19 pandemic and findings used to ultimately inform planning and decision-making.

Specific objectives

a) To assess patterns and trends in access to SRH services between the periods April 2020 - December 2020 compared to April 2019 - December 2019 in selected health districts including the performance of key SRHR indicators.

b) To interrogate the supply and demand side factors influencing the accessibility and use of essential SRH services between April 2020 - December 2020.

c) To assess the impact of COVID-19 on fertility in the country. d) To generate action-oriented recommendations to address the challenges and gaps identified.

Major Activities/Expected Deliverables

a) The design/inception report by the end of the first week of the consultancy

b) The draft report in MS Word ,etc by the sixth week of the consultancy

c) The final report plus ppt summary of the Report, revised on the basis of feedback provided by the reference group Duration and working schedule: The assignment shall not exceed a period of 35 working days spread across 3 months (payment will only be towards the 35 working days)

 

Application process: Interested candidates should email applications to mollentze@unfpa.org