Terms of Reference
International Consultancy to conduct end line surveys and evaluate
projects on prevention and response to teenage pregnancy
Background
All teenage pregnancies, irrespective of the outcome, have adverse consequences for the
girls, the parents and the communities. Adolescent pregnancy is dangerous. As it is
demonstrated in the document “A glimpse into the World of Teenage pregnancy” (UNICEF
2010), the poorest girls in the poorest communities in Sierra Leone are most likely to become
pregnant during adolescence, with serious long-term and wide-ranging consequences – from
health complications (for young mother and the baby) to broader economic concerns. Indeed,
pregnancy is the leading cause of death for adolescent girls and the youngest girls are
particularly at risk (WHO, 2012, Maternal Mortality Global report). Adolescents, and
particularly young adolescents, are more likely to have long and obstructed labors due to their
smaller size and immature pelvic structure. This not only increases their risk of death, but
also their risk of developing fistula. Finally, unsafe abortion kills many pregnant adolescents;
it is estimated that one-third of teen pregnancies end in abortion (WHO 2012, Adolescent
Pregnancy Fact Sheet).
Babies born to adolescent mothers are also at greater risk. A recent systematic review found
that adolescent pregnancy was associated with premature delivery, stillbirth, fetal distress,
birth asphyxia, low birth weight, and miscarriage. Babies born to teen mothers are also far
more likely to die than those born to older women. “Stillbirths and death in the first week of
life are 50% higher among babies born to mothers younger than 20 years than among babies
born to mothers 20–29 years old.” (WHO, 2012).
In general, evidence show that girls do not receive any information about puberty and sexual
and reproductive health, even from their mother. The UNICEF “Menstruation Management
Study” highlights that menstruation are considered taboo, until girls have their first periods.
In-depth interviews (UNICEF 2010) with teenage mothers and pregnant teenagers reveal a
feeling of isolation, ‘being trapped’ and helplessness. Teenage mothers or pregnant teenagers
have no one to talk to about what they are going through. There is very little or no psychosocial support for pregnant teenagers during the pregnancy or after the birth of their child.
The strain in the relationship with their parent(s) due to untimely pregnancy, the
dissatisfaction with the amount of education they received, and the inability to receive
consistent and quality health care are some of the factors that contribute to the feeling of
depression.
The impacts of adolescent pregnancy are felt far beyond the walls of the family home. It also
has a demonstrable impact on the social and economic development of communities and
countries (Bruce and Bongaarts, 2009). A report by the World Bank highlighted the lifetime
opportunity costs of adolescent pregnancy on national economies. They ranged from 1% of
gross domestic product (GDP) in China to 12% in India, and 30% in Uganda. In India,
adolescent pregnancy was estimated to lead to “over $100 billion in lost income, an amount
equivalent to twenty years of total humanitarian assistance world-wide”. (Chaaban and
Cunningham, 2009).
Much of this impact is channeled through girls’ education; each extra year of schooling a girl
receives is estimated to raise her income by 10–20% (Patrinos, 2008), with returns on girls’
education higher than those of boys. There is a strong evidence base demonstrating that
keeping girls in school and delaying their first pregnancy is a win–win situation, which has
the potential to cascade through generations.
In Sierra Leone, teenage pregnancy was identified as the second most prevalent child abuse
practice by community members and this was found out by an Action Research for Evidence
Based Policymaking conducted by UNICEF Sierra Leone (2009). Other national reports
have also indicated that an earlier age for sexual activity occurs in the country but the
national data does not reflect the extent of the problem. The Sierra Leone Out-of-School
Study identified ‘high pregnancy rate’ amongst primary and secondary school children as a
strong contributing factor as to why school-aged children drop out of school.
As a result of this, UNICEF Sierra Leone, commissioned a six-month nationwide study in
2009 on understanding the dynamics of teenage pregnancy in the country. The study was
commissioned to collect evidence and establish baseline information on present practices in
addition to social and economic dynamics that promote and encourage teenage pregnancy and
teenage motherhood. The report “A Glimpse into the world of Teenage Pregnancy in Sierra
Leone” was finalized in 2010. The findings of this report informed the areas of programming
by the Child Protection section in 2010-2012. The aim of this initiative was to reduce the rate
of prevalence of teenage pregnancy in country with pilot projects in seven districts.
Partnerships were established with the following partners to pilot the project: Child Fund,
Council of Churches, Save the Children, Restless Development and later BRAC. Based on
the recommendations of the report, these partners undertook activities that geared towards a
reduction on teenage pregnancy in the country. Different strategies were used by the
implementing partners in addressing the problem of teenage pregnancy.
Child Fund sought to address the problem of teenage pregnancy through the adoption of
positive deviance approach. This behavioral and social change approach aimed at finding
community based solutions to or behaviors solving salient problems supporting community
members to adopt and practice these positive behaviors. Community structures were
established through which teens were encouraged and empowered to address teenage
pregnancy concerns ensuring continual dissemination of positive deviant approach messages
to teenagers. In schools, teens were supported through health fairs with the help of PHU’s
and Community Health Workers in their communities.
Save the Children used a multi-dimensional approach in addressing the root causes of teenage
pregnancy. Firstly, the project worked to ensure that the legal/policy framework protecting
children (in particular girls) from Sexual Exploitation and Abuse (SEA), Gender based
violence (GBV) and teenage pregnancy is strengthened and efforts to combat impunity for
perpetrators of GBV and SEA are undertaken. This included: providing technical support and
actively coordinating and advocating at the national and District levels; supported the
formulation, implementation and independent monitoring of bye laws; and supported the
development and implementation of a District advocacy strategy and advocacy actions. The
project also worked to increase children’s access to and the coordination and child
friendliness of services to prevent and respond to GBV, SEA and teenage pregnancy
Council of Churches in Sierra Leone on the other hand, recognized that moving from
childhood to adolescence is a difficult period of development, when boys and girls are
bombarded with sexual messages from various sources, including TV, music, magazines and
peer group pressure. To help them deal with this period in their lives. CCSL has worked with
children, parents, and teachers in schools to support them in developing social and emotional
skills that will promote positive behaviour and effective learning. It involved providing them
with the skills and knowledge to make safe decisions regarding their sexual behavior. The
project increased teen’s confidence in their ability to develop stronger positive attitude/beliefs
about
abstinence/sex, increase their knowledge about prevention of HIV, STDs and
pregnancy and a lower incidence of STD/HIV risk-associated sexual behavior.
Restless Development engaged teenagers through peer to peer education, youth friendly
resources centers, youth action clubs and student action groups operated by volunteer peer
educators, they provided a core package of services to support young people in their SRH
choices Sexual and Reproductive Health (SRH) and Life skills (LS) education. Through their
youth friendly resource corners and youth action clubs, the Programme is able to reach in and
out of school youth with a wide range of support, including SRH, LS and HIV/AIDS
information services.
Purpose and rationale
The purpose of this international consultancy is to conduct the end line surveys and to
evaluate the various interventions undertaken by implementing partners of UNICEF in
addressing teenage pregnancy and assess the success of the intervention to the beneficiaries
(teenage pregnant girls, teenage mothers and other teenagers/adolescents) in the operational
areas UNICEF is working. The outcome of this end line survey and evaluation will inform
the child protection programming in the Rolling Work Plan for 2013-2014.
To conduct the evaluation, UNICEF will recruit an international consultant with experience
in the development and evaluation of child protection, preferably teenage pregnancy or GBV
interventions in different parts of the world. This experience will be crucial in understanding
interventions implemented in country and in designing recommendations for further actions
to address teenage pregnancy.
Expected Deliverables
 Concept note for the evaluation
 Report on analysis of the baseline and end line surveys
 Evaluation tools
 Draft report/presentation of the initial findings for discussion with stakeholders
 Final report on the impact of the teenage pregnancy interventions and lessons learned and
recommendations.
Methodology
The international consultant will work with four national consultants who will assist in the
data collection, organize meetings, and act as interpreter for the international consultant as
and when necessary.
 The international consultant will do desk reviews of the project proposals, progress
reports from implementing partners, datasets, baseline survey reports and other
relevant documentation.
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Discuss the concept note with relevant UNICEF sections, National Child Protection
Committee, National Committee on GBV, UN organisations, Implementing Partners,
Strategic Planning Unit and relevant Ministries for their input;
Develop the evaluation design, tools and matrix;
Develop tools to conduct end line surveys
Supervise the team of national consultants
Conduct the necessary orientation and training and pilot the evaluation tools
developed;
Finalize the tools developed and embark on field work for data gathering;
Conduct end line surveys
Collation of data and develop first report presenting the findings
Identify key interventions that have worked in reducing teenage pregnancy and assess
their success in reducing teenage pregnancy.
Identify interventions that have not worked and have not contributed to reduction in
teenage pregnancy and assess why these interventions have not worked.
Identify lessons learned and recommendations.
On the basis of the gathered information and in consultation with policy makers and
communities, identify potential courses of action including scale up of interventions
that have worked to address the incidence of teenage pregnancy and the social impact
for the girls and their babies.
Develop tools for monitoring and data collection for recommended actions
Presentation of initial findings in the context of a meetings with key policy makers
and stakeholders to validate the findings and develop recommendations
Finalization of report after incorporating comments received.
Geographical scope
The end line survey and evaluation will cover all districts where prevention and response to
teenage pregnancy interventions have been conducted by implementing partners: Pujehun,
Koinadugu, Kailahun, Kono, Bo, Kenema and Bombali.
Supervision:
Under the supervision of the OIC of the Child Protection Programme, in consultation with the
Chief of Education, Chief of Child Survival and Development and Chief of Planning,
Monitoring and Evaluation, and in collaboration with the Child Protection Specialist, the
international consultant is expected to produce the above mentioned deliverables.
Responsibilities of the consultant
 Ensure that all deliverables outlined in this ToR are carried out
 Give the property rights of documents produced to UNICEF
 Secure own laptop
Responsibilities of UNICEF
 Provide logistical support to enable field trips of consultant where necessary
 Provide access to documentation and support meetings with partners when and where
necessary
 Providing access to internet if necessary.
Time frame
 The duration of the consultancy will be for 8 weeks, starting as soon as possible.
Qualifications
 Minimum of a Master’s degree in a social science (e.g. Sociology, Anthropology) or
Monitoring and Evaluation or equivalent in experience
 At least eight years of progressively responsible work experience at national and
international level with sound knowledge, experience and technical skills in the area
of Child Protection, GBV and M&E
 Experience in undertaking qualitative research, assessments and evaluations
 Excellent interpersonal, communication and organizational skills
 Excellent analytical and documentation skills
 Adaptability and flexibility, confidentiality, initiative, concern for accuracy and
quality
 Knowledge of and experience in working in West Africa (preferably Sierra Leone) in
the area of Child protection, teenage pregnancy and GBV is an asset.
Recommended level for consultancy and terms of payment
 This task requires a consultant at P4 level
 Payment will be done on deliverables
 International return travel from the consultant’s home country to Freetown (economy
class)
 Transport costs to and from the airport
 Applicable DSA rates
Source of funding
Indicate the source of funding to cover the contract.
UNICEF RWP 2013 3.3.9
SC 090407 – Expiry date: 30th June 2013
Prepared and requested by: Dhuwarakha Sriram - OIC, Child Protection Section
Rosina Mahoi - Child Protection Specialist
Approved by: Yaron Wolman, OIC of the Country Office