CALL FOR PROPOSALS
For an assessment of the experiences of long term FP methods adopters and
discontinuers who have obtained FP services through the MSIA social marketing
programme in Afghanistan
1.
Summary
Marie Stopes International is a results-oriented social business that uses modern management
and marketing techniques to provide family planning, reproductive healthcare and allied
services. Marie Stopes International Afghanistan (MSIA) supports the Ministry of Public Health
(MoPH) to improve access to maternal, child and reproductive health services in provinces
through provision of high quality clinical services, technical support and training, advocacy and
IEC activities and social marketing services. The programme contributes to the achievement of
MDGs 4 and 5.
MSIA provides high quality, client-centered SRH/ FP information and services through its fixed
and mobile clinics and community based health workers located in four target provinces of
Afghanistan. MSIA also provides door to door services through its network of Community
Based Distributors (CBDs) who provide information on birth spacing and supply short and long
term contraceptive commodities to clients in MSIA target areas.
A consultant team is being sought to conduct an independent assessment, to better understand
the experiences of MSIA clients who have chosen to adopt or discontinue long term family
planning methods. This will include an investigation of the factors underlying client choice and
health seeking behaviour. It is expected that the consultant team will use both qualitative and
quantitative approaches to conduct this assessment, including interviews with CBDs, clients
and clinical service providers in programme areas. The consultancy will begin in 16th December
2014, and must be completed within 3 months.
MSIA invites proposal submissions from qualified consultant(s) that identify methodologies, key
personnel,1 an estimated timeline to complete this review and an indicative budget.
2.
Background
Afghanistan’s pervasive poverty and more than two decades of war and continuing conflict have
led to an environment where many women lack basic rights, including the right to quality health
care. Not only do women in Afghanistan face pervasive levels of violence and gender inequity
1
Personnel required to carry out the evaluation e.g. technical lead, field work team, data analysis personnel, etc.
but also inadequate access to SRH and maternal health services leading to some of the lowest
levels of reproductive health in the world.
Access to family planning is one of the most cost effective approaches to reducing maternal and
child mortality2. Increased access to quality family planning services has a development impact
that goes beyond health outcomes alone. It is critical that women and their families have
sufficient information and services to allow them to make informed decisions about the size of
their families and the spacing of their pregnancies.
Although reproductive health is a priority in the national development strategy and within the
Ministry of Public Health (MOPH), there remain gaps in the capacity and resources required to
provide these services to the level required, including the MCH component of the Basic and
Essential Packages of Health Services (BPHS/ EPHS). This has resulted in a low level of
delivery and utilisation of these services, particularly in rural and remote areas.
Marie Stopes International was established in Afghanistan in 2002 and works in partnership with
the Ministry of Public Health, Ministry of Religious Affairs and Ministry of Women’s Affairs to
delivery appropriate sexual and reproductive health services and MCH services and information
to the community, in line with the BPHS. MSIA is a sub recipient of contraceptives from UNFPA
and works closely with UNFPA, local and international NGOs and religious, community and
political leaders.
MSIA currently operates a network of 11 mobile and fixed clinics, providing high quality SRH
information and services to underserved communities in four provinces of Afghanistan. FP
information and products are also provided through its Contraceptive Social Marketing (CSM)
programme that includes a network of 37 Medical Representatives, Sellers and Community
Based Distributors working in seven provinces of Afghanistan.
The ‘basket of goods’ offered by MSIA Community Based Distributors currently includes
pregnancy tests, contraceptive pills, injectables and IUDs. However, although IUDs are a
popular choice, less than 5% of women who purchase IUDs through this channel subsequently
attend an MSIA clinic for insertion of the IUD. Although MSIA has anecdotal information
concerning reasons for client choice and subsequent use of this method, there has not yet been
any formal assessment of social marketing client preferences and experiences.
In addition, MSIA has found that numbers of women who attend MSIA clinics for IUD removal
are slightly higher than might be expected for a programme of this size. This assessment will
also look at reasons why women who come to MSIA clinics for IUD removal choose to
discontinue use of this method.
This evaluation will work with Marie Stopes International Afghanistan senior programme staff,
provincial coordinators, social marketing field teams, MSIA clinical staff and clients to conduct
this assessment. The review should help inform possible options for improving the quality of
family planning service provision in MSIA target areas, increasing access to long term FP
methods and MSIA clinical services, improving the effectiveness of community-based social
2
Afghanistan Mortality Survey 2010, November 2011
marketing services and ensuring that these services are appropriate to the context and needs of
our clients.
3.
Objective of the Independent Review
The objective of the evaluation is to obtain feedback from women who have received an IUD
through the MSIA social marketing program, and specifically: 1.) to better understand the
reasons that they have chosen this method of contraception, 2.) whether clients subsequently
go on to use IUDs obtained through the social marketing programme, 3.) where they seek
assistance for insertion of the IUD; and 4.) what is their experience of using this method of
contraception.
Travel to at least two provinces in Afghanistan, in addition to Kabul, will be required.
The key research objectives include:
Among MSI-A Social Marketing Clients:
 IUD-specific research:
o Identify the reasons that MSIA social marketing clients choose to purchase an
IUD.
o Identify what percentage of women who purchase an IUD fall into the following
groups: 1.) users of the IUD (i.e., women who insert the IUD within one month of
purchase of the IUD); 2.) non-users of the IUD.
 Of the ‘users’:
 Are these women existing users or new adopters of FP and long
term FP methods?
 Where do they go for insertion of the IUD and what are the
reasons for this choice?
 What are the factors that encourage social marketing clients to
visit an MSIA clinic for IUD insertion and what are the barriers?
 Of the ‘non-users’:
 What are the reasons that they did not use the IUD?
o What is the experience of MSIA social marketing clients who use or have
previously used IUDs? Are they satisfied with this form of contraception?
 All-method research:
o What was the quality of counselling that the clients experienced from the CBDs?3
Among MSI-A Clinic Clients:
 What are the main reasons that women choose to have an IUD removed at on MSIA
clinic?
 What are the main reasons that women don’t accept to have an IUD insertion on MSIA
clinic?
3
We are interested in learning about quality of counselling from clients, but also potentially mystery clients/more
observational methods of research.

4.
What types of IUD insertion are chosen by clients in MSIA clinics?
Conducting the Consultancy
The consultant(s) will report to MSIA and will be responsible for managing the independent
evaluation and coordinating related in-country activities. The Marie Stopes International
Research, Monitoring & Evaluation Team will conduct technical review of the research protocol,
as well as the final report and power point presentation. The consultancy will begin in 16th of
December 2014 and must be completed within 3 months.
5.
Deliverables
The consultant will be required to produce the following deliverables:
1. Desk review of documents relevant to the work of MSIA and the Afghanistan context,
including project and policy documents, service statistics, activity and evaluation reports
prior to commencement of field work.
2. Initial meeting with MSIA to discuss evaluation objectives, timetable and proposed
activities, methodology and field work.
3. Study methodology and protocol (to include background, objectives, literature review,
research questions, study design and sample size/sampling plan, data collection
procedures, evaluation work plan, data management and analysis plans, ethical
considerations, including informed consent forms, and discussion of study limitations);
4. Data collection tools (e.g. quantitative survey, focus group discussion topic guides,
semi-structured interview guides, in-depth interview guidelines, etc.);
5. Set of the raw data collected (including but not limited to: quantitative survey data,
qualitative survey data—e.g., transcripts, video recordings, etc.);
6. Set of any analysis tools used (Excel files, statistical software syntax, qualitative
thematic analysis, etc.);
7. Workshop with MSIA to present the findings of the evaluation and collect their
feedback concerning the evaluation;
8. Final PowerPoint presentation with summary of methods, results and
recommendations; and
9. Final evaluation report to include evaluation methodology, results, discussion of
findings, recommendations and conclusion. The report should include feedback from
partners and an executive summary that does not exceed 3 pages.
6.
Specifications of the Consultant(s)
The consultant(s) should have relevant experience and knowledge in:
 Monitoring and evaluation of health and development projects, in particular field level
projects aiming to improve the health and well-being of women in a conservative
community setting;
 Qualitative and quantitative research methods;
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Family planning, sexual and reproductive health and maternal and child health
programs and services within a developing country context, in particular Afghanistan;
Experience of social marketing programming and principles; and
Demonstrated cross-cultural understanding and experience of conducting research into
sensitive issues in a restrictive environment.
An understanding of key cross cutting policy issues, in particular gender, disability,
environment and HIV/ AIDS.
Excellent written and verbal communications skills in both English and Dari.
1. Submission Guidelines
MSIA invites qualified consultants to submit proposals to undertake this review. The proposal
should:
a. outline how the consultant(s) meets the required specifications (outlined above);
b. specify methodologies, key personnel an estimated timeline or schedule to undertake
this review (including key activities) and an indicative budget.
Proposals should not exceed 10,000 US$.
Proposals are due by close of business on 08th of December, and should be emailed to:
Mr. Munir Zalmy , Procurement and HR Team Supervisor
Hard Copy of Application and CVs to: House# 154, 3rd street, Karte 4, District 3 Kabul Afghanistan
Phone: 0093-752011504
Mail: vacancies@msi-afg.org/admin.log@msi-afg.org