Child.org and HealthStart

Child.org are a bunch of people dedicated to one thing and one thing only: building a world where every child has an equal opportunity. We are passionate about designing and constantly developing our programmes to be as effective as possible. We do what works. 

HealthStart is Child.org's flagship school health programme. The programme aims to reduce absenteeism and drop out levels in primary schools by tackling a whole specrum of health issues, thereby improving student performance. HealthStart is funded by Comic Relief and is currently being implemented in 25 schools in Western Kenya, Kisumu County, aiming to benefit at least 10,000 school children. This second phase of the programme has been running for two years. Our initial, pilot phase of HealthStart ran previously in two schools in the same region.

Our 25 HealthStart schools are in Muhoroni and Nyando Sub counties in Kisumu, which is a malaria endemic region. The schools are grouped in five clusters: Angoro, Ayucha, Milenya, Nyatao and Ngeny. 

As we draw towards the end of this second phase of HealthStart, Child.org need to evaluate the programme comprehensively, to find out what's working well and what we should change in the future.

HealthStart works by: 

  • Strengthening systems

  • Teaching health skills

  • Involving the community - Health Clubs  are set up, with children and parents as members

  • Providing health services, including access to mosquito nets and deworming tablets

  • Providing and using data - schools are taught how to capture and share health results

How does HealthStart work?

HealthStart works with the schools, local government and communities to implement a clear and effective framework to deliver school health and nutrition interventions. The aim is to improve educational attainment, by keeping more children healthy and in school.

The robust framework that the programme establishes within the school is designed to ensure that health interventions have a long-lasting, sustainable impact on every pupil. The project also works with different stakeholders to strengthen their ability to gather, interpret and act on health data.

Activities implemented by HeathStart include:

a) Systems Strengthening 

HealthStart works in each school to strengthen governance through their Board of Management. We introduce the Kenya National School Health Policy of 2009, form a School Health Committee and a Health Club. We also create internal structures and partnerships with the relevant line ministries. This means the school can ensure the government provide them with health services, and hold local ministries to account for any failure to deliver. 

b) Health Education

The HealthStart programme works with local and county level representatives from relevant ministries, as well as teachers, to understand the programme framework. We supply schools with engaging content to communicate the key health messages of the Kenya National School Health Policy of 2009 within schools, circulating health advice and promoting healthy behaviours.

c) Community Mobilization

Health Clubs provide children with a structure through which to advocate for their rights and hold the School Board of Management to account when their needs are not met. Parents are better informed on the health and wellbeing of their children through the introduction of school health report cards that include a summary of their child’s nutrition status.

d) Health Services

Each school went through a comprehensive needs assessment process, to establish existing resources and service provision and identify potential areas of improvement. This information was used to tailor the interventions to each school. The package in different schools included: deworming, nutrition specific interventions, Long-lasting insecticide-treated nets, improved sanitation, and health education. The data we collected was inputted to the Kenya Demographic Health Information System, to inform future government decisions.

Expected programme outcomes

  • Representatives from all stakeholders (children, teaching staff, school managers and caregivers) will have improved access to understanding and knowledge on how to stay healthy
  • The sustainability and longevity of health interventions will be improved
  • New relationships will have developed that will improve health for children and communities
  • Channels of communication between different stakeholders will be improved
  • Stakeholders will have a better awareness of their rights
  • Children and other stakeholders will be empowered to become agents for change. They will feel able to advocate for positive change in their school and community
  • Schools will have improved access to technology for data collection, storage and sharing.
  • School will have a good understanding of the importance of data. They will be able to use it to learn about key trends and needs within their community, and develop activities based on their findings

Our partners and their roles

Child.org has partnered with two organisations to implement the HealthStart program; Ogra and Omega Foundation. Each partner focuses on specific areas of programme delivery that complement their strengths and experience.

Omega Foundation are experts at providing mentorship, capacity building and systems strengthening to community organizations in and around Kisumu County. For HealthStart, Omega take the lead in the processes of systems strengthening and training in each school, and also lead on community sensitisation. They were responsible for intentifying stakeholders at the start of the programme, and ensuring they were all mobilized and had the capacity to understand their roles in the school, as stipulated in the Kenya National School Health policy. Omega then also provide regular mentorship for stakeholders throughout the programme, to ensure the policy is well understood and implemented. 

Ogra Foundation implemented our HealthStart pilot programme, so they have an in-depth understanding of the challenges involved when delivering health interventions in schools. Ogra therefore take the lead on health service delivery, working closely with the Ministry of Health to ensure mosquito nets, deworming tablets & vitamin A supplements are available and properly administered. Ogra also manage regular dialogue meetings in all 20 schools, bringing Government partners, school health clubs and school management together to ensure the National School Health Policy is understood and implemented by all stakeholders.

The evaluation

Why are we conducting this evaluation?

We want to conduct an end of project evaluation, to assess the progress of the programme and the challenges it has faced over the past two years. The evaluation will need to assess the relevance, effectiveness, efficiency, sustainability and impact of the programme. It will help us find out if HealthStart is benefitting the people it is targeted to benefit, and make note of any gaps in provision - and how these have affected the programme. 

By analysing the effectiveness of our programme's approach and strategy, we will be able to inform and improve the next iteration of HealthStart.

Evaluation objectives

  • To assess the relevance, effectiveness, efficiency, sustainability and equity of the programme's benefits to its targets
  • To determine the level of change delivered by the programme, by comparing baseline and end-term review data to show the progress on specified indicators and outcomes
  • To assess the effectiveness of the partnership between the three organizations (Child.org, Omega and Ogra) in delivery of the HealthStart programme. 
  • To draw key learnings from the programme, and recommend replicable elements for the next iteration of HealthStart

The scope of the work will include...

  • A desk review of the baseline survey, including a review of the data collection tools 
  • Visits to all 25 HealthStart schools to conduct school health audits
  • Self-completion surveys for all class 7 & 8 pupils at each of the 25 schools
  • Interview surveys with sample groups of parents and caregivers from each school (conducted on house to house visits) 
  • A visit to Ogra and Omega offices in Kisumu County to conduct partner evaluations
  • The presentation of evaluation findings, including a summary of key findings and recommendations, to Child.org

Duration of evaluation

The evaluation has been scheduled to take place for a period of four weeks between 2nd March and 20th April 2018. (This will ensure that the pupil survey does not coincide with end of term exams or the April holidays.)

Expected deliverables

  • A proposal, detailing the understanding of the terms of reference and proposed methodology
  • The proposal should include an outlined budget for planned activities
  • Administration of three surveys/three survey tools: pupil survey, caregiver survey and school health audit
  • A partnership evaluation to be undertaken for each of the partners, resulting in a partnership evaluation report
  • A full evaluation report

Methodology

The consultant will be expected to propose your own methodology to Child.org, with final agreement of the methodology coming from Child.org.

It will be expected that the methodology will include, among other components:

  • A review of the baseline survey and tools used in the programme
  • Carrying out school visits to undertake school health audits
  • Administration of the pupil and caregivers’ surveys
  • Carrying out partner evaluations for each of the partners

Required expertise and qualification

The consultant carrying out this evaluation will be expected to have:

  • An advanced degree in Public Health/Community Health/Social Sciences
  • Proven experience working in health and education programmes
  • Strong report writing skills
  • Proven experience conducting education and health research

Exposure or familiarity of working in Kisumu County will be an added advantage.

Application requirements

All expressions of interest should include:

  • The experience of the company or individual (including testimonials and a copy of a report of similar work)
  • A capability statement, including:
    • Curriculum vitae of key personnel
    • Appropriate references and relevant testimonials
    • Your availability for the assignment
  • Technical Proposal (maximum five pages) highlighting:
    • A brief explanation about the consultant(s), with emphasis on previous experience in this kind of work
    • A profile of the consultant(s) to be involved in undertaking the evaluation
    • Understanding of these terms of reference and the task to be accomplished
    • A draft work plan
  • Financial Proposal. This should provide cost estimates for services rendered, including daily consultancy fees. Consultancy fees quoted should be fully inclusive of costs such as accommodation, living costs, transport, stationeries, and supplies needed for data collection and all other costs related to persons that will take part in the evaluation process, etc. Data collection and data processing costs should be included in the consultancy fee. Please note that the consultant is also expected to use their own computer.

All applications should be sent to Cherio at hellokenya@child.org by 31st January 2018.