Annex B Terms of Reference (Tors) : Title: National Assessment On Adolescent Pregnancies in Zimbabwe
Annex B Terms of Reference (Tors) : Title: National Assessment On Adolescent Pregnancies in Zimbabwe
BACKGROUND
Adolescent pregnancy refers to pregnancies occurring among girls below the age of 20 years
at the time the pregnancy ends. The rate of teenage pregnancy is generally measured by
adolescent fertility rate. Globally, adolescent pregnancy remains a major challenge and is a
major contributor to maternal and child mortality and to the vicious cycle of ill-health and
poverty. This pregnancy takes an enormous toll on a girl’s education, income-earning
potential, health, and well-being of her child. The girl is also at risk of contracting sexually
transmitted infections including the Human Immunodeficiency Virus and transmits the
infection to her unborn baby.
Every year, an estimated 21 million girls aged 15–19 years in developing regions become
pregnant and approximately 12 million of them give birth. Majority of the pregnancies are
unintended and may sometimes be the result of sexual violence. Approximately 83% of
teenage pregnancies occur in low- and middle-income countries such as Zimbabwe1. The
global average adolescent fertility rate was estimated at 44 births per 1,000 women aged 15–
19 years in 20182. Zimbabwe with an adolescent fertility rate for women aged 15-19 years
of 108 per 1,000, is among the countries in sub-Saharan Africa with a huge problem of
1
https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
2
UN Population Fund, UN Department of Economic and Social Affairs, Population Division 2018
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adolescent pregnancy. In Zimbabwe, adolescents contribute an estimated 25-30% of maternal
deaths.
There is wide recognition that the factors associated with teenage pregnancies are complex
and multifaceted and are a result of the interplay among individual, family, school/peer,
community, policy, and national level factors. The multifaceted nature of this challenge,
requiring policy and programmatic interventions as well as innovation in areas such as
economic empowerment, education, health, protection, inclusion, gender equality and
culture, also underscores the importance of collaboration.
The study will gather adequate qualitative and quantitative information on the nature and
extent of the problem of adolescent pregnancies in Zimbabwe. This information is critical
for developing effective policies, programmes, and interventions that will better target these
adolescents and expand opportunities for affected adolescents in Zimbabwe. The study will
also help to improve coordination from national to local level towards the realization of the
increased efficiency in the delivery of services to respond to the needs of these adolescents.
Ultimately it will provide the evidence base for the possible redesign of both at policy and
structural level of pregnancy reduction programmes towards better outcomes for
adolescents
The overall objective of this assessment is to determine the character and scale of the problem
of adolescent pregnancies in Zimbabwe. The assessment will examine the causal factors
contributing to the problem as well as identifying existing or alternative programmes being
offered and the groups of adolescents benefiting from them.
The study aims to identify root causes leading to adolescent pregnancy. It also aims to
understand the pathways and experiences of a cohort of adolescents who have fallen pregnant
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before the age of 20, to gain a deeper understanding of their experiences, needs and map the
much-needed support to tackle adolescent pregnancy. The study will:
a) Examine literature to establish data and trends of adolescent pregnancy in the last five
years.
b) Identify and examine factors leading to adolescent pregnancies by sub-groups,
location and. source perspectives from boys, parents and community leaders and
others.
c) Examine how the COVID-19 pandemic has influenced adolescent pregnancies.
d) Develop comprehensive and detailed profiles of a sub-set study participants who
experienced adolescent pregnancy, expounding on who are they, where are they and
analyse what effect, if any, the individual, community, school and contextual factors
have on adolescent pregnancies, did they know their HIV status before pregnancy,
were they tested during pregnancy and/or after and the current status (considering
confidentiality-can check child health card).
e) Identify differences, if any, in trends and factors affecting pregnancies, including by
age, geography, socio-economic status and disability status if feasible.
f) Examine what opportunities are available to adolescents to prevent pregnancies.
g) Examine the post-pregnancy experiences of adolescents who fall pregnant, and their
children including growth monitoring, Infant and Young Child Feeding practices and
Early infant Diagnosis for those HIV exposed. Source perspectives of boys, parents
and community leaders and others.
h) Identify and profile government, civic society and commercial organisations and
individuals offering preventive and mitigation programmes and interventions.
i) Identify and examine Laws and Policies that address issues of Child Sexual Abuse,
and
j) Make strategic recommendations that more adequately respond to the diverse needs
of adolescents and will guide the design of programmes to reduce adolescent
pregnancies in Zimbabwe.
The selected partner/firm will be responsible for the design and implementation of the study
over a period of 6 months. The major tasks involved are the following:
1. Literature Review: Undertake an extensive review of national, regional, and
international literature on adolescent pregnancies, to identify key factors affecting
adolescent pregnancies.
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3. Sample (cohort) selection: Propose a sampling method that will result in a sample that
reflects the diversity of the Zimbabwean adolescent population. This method should
conform to the Gender and Human Rights based research methods and take cognizance
of factors that affect drop out including wealth, gender (boys and girls), disability
status, geographic location, and contextual factors. To that end, the proposed approach
should be stratified to ensure various categories of adolescents are included in the study,
including those with disabilities.
4. Data Collection and Analysis: The partner’s methodology will include a strategy and
plan for collection of data to address the study objectives. The data collection plan
should provide details including the types of data, sources, frequency of data collection,
models, and methods to be used. In addition, a strategy setting out the approach to and
types of analysis that will be done to achieve the objectives. The analytic strategy
should also include analysis of secondary data.
7. Final Report: The consulting firm or team of consultants is expected to develop a final
analytic report with policy options based on the results of the study; and Final database
and debriefing of participants.
METHODOLOGY
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c. What are the drivers of adolescent pregnancy? What categories can these drivers be put
in? Are there voluntary or involuntary factors that lead to the pregnancy? (categorise the
factors by voluntary and involuntary)?
d. Does falling pregnant involve an active process of making decisions on the part of
adolescents, and if so, what are the critical decision points and the factors contributing to
these decisions? If not, how many adolescent girls fall pregnant without taking an active
decision, for instance because of gender-based violence, lack of knowledge, and disability?
e. What factors pre-dispose the adolescents to the pregnancies? How do these factors
predispose the adolescents?
f. What are the perspectives of boys, parents and community leaders and others on
adolescent pregnancies?
g. Are there girls aware of HIV and syphilis, testing and care and treatment and their
perceived risk to HIV, syphilis and transmission to their babies.
h. What are the post-pregnancy experiences of pregnant adolescents?
i. What are the effects of adolescent pregnancies?
j. What are the pathways pursued by adolescents who fall pregnant?
k. What opportunities are available to adolescents to prevent pregnancies, and what is their
capacity?
l. What proportion of pregnant adolescents benefit from these opportunities?
m. What is the profile of government, civic society and commercial organisations and
individuals offering programmes and interventions to prevent and or respond to the
challenge and effects of adolescent pregnancies?
n. What is the combination of economic and social programmes and policies should be
considered to reduce the number of adolescents who experience pregnancies before the
age of 20?
To achieve the objectives of study, and address the specific issues of the assessment, the
information and other data will be collected both from secondary sources and primary
sources. The following methods provide guidelines to support prospective bidders in
designing their methodology:
• Literature Review: The consulting firm or team is expected to conduct an extensive
review of national and international literature on adolescent pregnancies, to identify
key factors that contribute to this challenge. A list of documents to be considered is
provided in the appendix. The literature review is expected to inform the design of
the study, types of data to collect and the analytic approaches to be used in conducting
the study.
• Secondary data analysis: Existing data bases from the Ministries of Health and
Child Care; Primary and Secondary Education and Public Service, Labour & Social
Welfare provide rich information on system wide indicators. This is a potential
source of data to identify numbers and understand the broader context. Reports of
previous studies conducted by from government ministries, co-partners, and other
development agencies as well the secondary sources may be used to extract
information. A list of documents to be considered is provided in the appendix.
Analysis and Report Writing: The consulting firm or consultants should propose a clear
strategy for analysing both the qualitative and quantitative data using techniques suitable for
each of the data types. It is expected that the analyses take advantage of the most current
approaches to quantitative and qualitative data analysis. Techniques should ensure sufficient
attention to issues of human rights and equity including dimensions related to gender,
disability status, social and economic status, and geography. The analysis should clearly
answer the questions outlined in the objectives and provide insights on transition, school
survival, retention and dropping out, using data collected during the study. The data analysis
should culminate in a final report on the study.
KEY DELIVERABLES:
The consulting firm or consultants is expected to conduct the following tasks and
satisfactorily complete the following deliverables according to the timeframe outlined
below.
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1. Inception The consulting firm or consultants will prepare an Within 30
Report and inception report which will outline how the study will days after
Desk Review. be carried out, bringing refinements and specificity to signing the
the terms of reference, and preparing a work plan and contract.
budget to conduct the study. This report should be
informed by a review of literature and other key
documents that will provide focus to the study. At a
minimum the inception report should also include the
following:
a) Interpretation of the study objectives.
b) A literature review consisting of an overview,
a summary, and a discussion of
methodological issues.
c) Methodology of the assessment.
d) Bibliography of documents to be reviewed.
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2. Comprehensive The consulting firm or consultants will develop a Within 60
Initial Draft draft analytic report summarizing findings, results days after
Report. and providing recommendations. The report will signing the
cover priority areas such as: contract
- Data on the prevalence of the adolescent
pregnancies,
- A complete record of all the pregnancy reduction
programmes.
- Profiles of a sub-set study participants who have
experienced adolescent pregnancy.
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3. Final Report. The consulting firm or consultants will prepare a final Within 90
comprehensive report, which reflects feedback from days after
stakeholders to the draft and summary report and signing the
meets the standards of quality. The comprehensive contract
final report should include findings, documentation of
good practices and lessons learned, and policy
recommendations. All final data collection tools and
datasets used and/or developed the process should be
submitted together with the final report for future
analysis, should the need arise. In addition to the
final report, the consulting firm or consultants will
prepare a PPT presentation on key findings and
recommendations which will be presented to the
Taskforce to spur discussions and inputs on both the
process and outputs.
PAYMENT SCHEDULE
Payments will be made according to the following schedule for satisfactorily completed
deliverables.
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III. ETHICAL CONSIDERATIONS
Ethical dimensions should be taken into consideration by the consulting firm or consultants,
discussed and technical and operational measures taken to ensure highest standards of data
protection at each stage of the assessment, from the design, collection, analysis, and
dissemination of data are observed. More specifically, prior to conducting interviews the
respondents’ informed consent should be ensured, age-appropriate language and approaches
to data collection involving children should be used. The anonymity and confidentiality of
individual data shall be protected. Consideration should be given to all the risks associated
with the processing of personal data and appropriate security safeguards to prevent any
unauthorised access, use and dissemination of personal data should be instituted. The
consulting firm or consultants shall not make use of any unpublished or confidential
information, made available while executing this consultancy, without written authorization.
The products of this consultancy are not the property of the consulting firm and cannot be
shared without the permission of the Taskforce on adolescent pregnancy through the Ministry
of Public Service, Labour and Social Welfare (MoLSW) and UNICEF.
Considering the sensitivity of the topic, it is important to consider that participants might
disclose events of violence and abuse during the interviews. In order to ensure the principle
of ‘do no harm’ is upheld, the consulting firm or consultants needs to put in place measures
to refer participants to relevant service providers in their respective location, and to train
enumerators in interviewing vulnerable participants. The referral pathway proposed by the
consulting firm forms part of the documentation submitted for ethical clearance.
The study is expected to cover a period of no more than six months from the date of
recruitment of the consulting firm or consultants. The consulting firm will be directly
supervised by the Co-Chairs of the Taskforce. A study review team consisting of officials
from the Taskforce on the Reduction of Adolescent Pregnancies established under the Child
Protection Thematic Working Group for this purpose will provide oversight to the process
and be responsible for providing feedback on and approving all submissions by the
consulting firm or consultants. In reviewing submissions, the working group will reference
the standards outlined in UNICEF’s Global Evaluation Reports Oversight System
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(GEROS) to assure the quality of reports. The approval of all reports, the basis of payment,
lies with UNICEF and MoLSW.
Zimbabwe (Harare) and selected districts for field research. The duration
of the contract is 3 Months.
QUALIFICATION REQUIREMENTS
The consulting firm or consultants must provide details of qualification, samples of reports
on similar evaluations, and a work profile. The lead consultant should meet the following
minimum criteria:
• Minimum Master’s Degree, in disciplines including (i) Public Health, (ii) Social Science
or other relevant fields; a PHD is an added advantage.
• Evidence of strong analytical and writing skills with the ability to document and report
in a clear and practical manner in English.
• At least 8 years’ experience in the field of research on adolescent health with strong
expertise using qualitative research methods.
• Evidence of in-depth knowledge of adolescent health issues.
• Expertise and proven technical competence in quantitative and qualitative data analysis.
• Knowledge of statistical packages and experience with field work and data collection.
• Current knowledge of key issues related to multidimensional child poverty and on
measurement of child deprivation and poverty, and determinants of child well-being
social policies; and
• Fluency in English and any of the Zimbabwean languages.
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Specific Proposal Evaluation Criteria
Technical Proposal Points
1. OVERALL RESPONSE
- Understanding of and responsiveness to the requirements of the TOR. 10
- Understanding of scope, objectives, and completeness of response.
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5. FINANCIAL
Assessment/review will include:
- Overall Price
- Cost benefit comparison related to number and quality of personnel
- Completeness of the Financial Proposal (ensure that all costs, including
professional fees, costs of travel, salaries, insurance, etc. are included in 20
the price offered).
- Payment terms/schedule of payment proposed.
- Timeline proposed.
- Period of validity of Proposal.
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