Scope of works for the evaluation of the Reproductive, Maternal Newborn Child and Adolescents Health (RMNCAH) program implemented by Americares Liberia in Grand Bassa County from 2021-2025.

Backgrounds

Americares is a health focused relief and development organization that saves lives and property and improves health for people affected by poverty or disasters so they can reach their full potential. Americares helps people and communities around the world access health in times of disaster and every day. Each year, Americares reaches 80 countries on average, including the United States, with life-changing health programs, medicine, medical supplies and emergency aid. Americares is one of the world’s leading nonprofit providers of donated medicine and medical supplies. For more than 45 years, we have met the health needs of our local partners and their communities. Our donors make it possible to get medicine and critical care for families and communities in need.

Currently, Americares is implementing the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) program in Liberia, Grand Bassa County. The RMNCAH program is one of Americares life-changing projects that promotes maternal and child health services in Grand Bassa County thereby contributing to the reduction of maternal and perinatal morbidity and mortality.

The RMNCAH project started with three (3) health facilities in October 2021, with collaboration from the Ministry of Health (MOH) and the Grand Bassa County Health Team (BaCHT). In April 2022 the project was rolled out to additional three (3) facilities, totaling six (6) health facilities. In July, 2024, due to the demand, and with strong collaboration with the Ministry of Health and the Grand Bassa County Health Team, the project was extended to six (6) new facilities, totaling twelve (12) public health facilities, accounting for about 52% of the total primary health facilities in Grand Bassa County.

The primary objective of the RMNCAH program is to improve Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) outcomes thereby contributing to the reduction of maternal and perinatal morbidity and mortality through the following:

1. Improving the quality of maternal and newborn care including antenatal care (ANC), postpartum hemorrhage (PPH), essential newborn care (ENC), and postpartum care (PPC).

2. Increasing the uptake of facility-based deliveries through community engagement activities.

Purpose and Objectives

The purpose of this evaluation is to provide an objective and credible assessment of the RMNCAH project, using external experts to provide an unbiased perspective on the program’s relevance, effectiveness, efficiency, sustainability, and impact.

The evaluation will provide evidence and learning that can be applied in future projects, and to the accountability of the project to its affected population and stakeholders where applicable.

Specific objectives are addressed in the section on Key Evaluation Questions.

Audience of the Findings

The main audience of the findings will be Americares and its primary partners (Ministry of Health and the Grand Bassa County Health Team), as well as the project beneficiaries.

Americares will use the evaluation findings to improve performance in the next phases of implementation, and to gather recommendations for new programming.

Americares will also use the evaluation findings to engage the beneficiaries through the Ministry of Health and the Grand Bassa County health team to confirm that the program’s intended results resulted in benefits, validating how accountable the program is to the project implementation sites.

Design and Methodology

The evaluation is expected to employ a mixed methods approach that will combine quantitative and qualitative techniques. The evaluation is expected to involve health care providers, members of the District Health Teams, County-Level Supervisors, and selected community members, and should include both desk review and field visits. The data collection techniques and key methods may include but is not limited to the following:

1) Desk review of project documents, assessments and other background documents, key informant interviews, focus group discussions, satisfaction surveys and observations. The suggested methodology for the evaluation should incorporate both qualitative and quantitative components.

2) Surveys, focus groups, and/or semi-structured interviews with key informants and other community groups such as Trained Traditional Midwives (TTMs) to collect information that cannot be assessed through the data tracker or the health facilities ledgers.

3) Observations from the field during service provision.

Evaluation Approach

An independent external team/consultant will be hired for the evaluation as the assessor. Americares team will provide support to the evaluation team throughout the data collection process. The evaluation team will develop standardized tools and question guides for supplemental data collection. The evaluation process will involve active participation from the project’s local partners and beneficiaries.

Key Evaluation Questions

Section 1: Community Engagement Interventions

Americares reactivated, strengthened, and supported Trained Traditional Midwives (TTMs) activities across its supported health facilities. Some activities implemented under this section included the following:

a. Support for the conduct of TTMs networking (engagement) meetings.

b. Initial training in use of the facility-based delivery (FBD) solution set and distribution of related job aids.

c. Link TTMs to CHSS/CHAs to strengthen coordination and community linkages to the health facilities.

d. Print and distribute IEC/BCC materials or job aids to visualize messages for use by TTMs in the communities.

e. Provision of supplies (starting package) to aid TTMs in the discharge of their functions, and for timely referrals.

Some outputs of these activities included the following:

a. The conduct of regular TTMs Networking Meetings (increase in the number of TTMs attendance).

b. Timely referrals of pregnant women for ANC services, FBDs, and postpartum services.

c. Increase knowledge in identifying danger signs during pregnancy and the postpartum period.

Key evaluation questions to be addressed under this section include but are not limited to the following:

1. Were the TTM activities implemented as planned (ie meetings held, logistics distributed/received such as feeding, transport, job aids)?

2. How have the TTMs maintained and sustained skills and knowledge from the TTM engagement activities?

3. What information did pregnant women receive from the TTMs during their pregnancy, how did they use that information, and how did they feel about the overall TTM engagement with them during their pregnancy?

4. What were the perceptions of the changes and satisfaction with the program (TTMs and HF staff)?

Section 2: Quality of Care Intervention

As part of its intervention to promote maternal and child health services, Americares also strives to improve the quality of health services provided to clients. Recognizing that the quality of health services is one of the most important determinants of health outcomes, Americares, as part of its implementation strategy, developed and implemented consolidated quality of care (QOC) tools

adapted from the Private Maternity Care – Quality Toolkit and based on WHO Quality of Care standards. The QOC tool focuses on four primary standards, including Antenatal Care, Essential Newborn Care, Postpartum Care, and Postpartum Haemorrhage. Each of these standards has unique sub-standards that address specific issues/conditions.

The QOC assessments were conducted across the Americares supported health facilities at select frequencies based on the program’s implementation strategy and included baselines and subsequent follow up assessments routinely.

Key evaluation questions to be addressed under this section includes but are not limited to the following:

1. How do Americares QOC findings and trends compare with relevant JISS standards and MoH spot checks?

2. Do QOC improvements overtime translate into improved clinical outcomes?

3. How do clinical and access to care outcomes (e.g., community-based deliveries, ANC usage (ANC 1 & ANC 4) and facility-based deliveries) compare between Americares supported health facilities and non-Americares supported health facilities?

4. From the HF staff, district, and county perspective, how satisfied are they with the Americares program?

Data Collection, Analysis and Reporting

The assessor will be responsible for conducting a desk review of project materials and documents provided by Americares, developing the evaluation methodology and data collection tools, ensuring data quality, analyzing the data, and writing the final report with key recommendations and responses to the evaluation questions.

The evaluation methodology should be designed to mitigate against any risks and or challenges in the local context (language barriers). The assessor should also work according to the principles of evaluation:

– Independence: measures should be put in place to prevent bias.

– Usefulness: final findings must be articulated clearly and in a way that maximizes the potential for these findings to inform decision-making.

– Representativeness: finals should strive to include a wide range of beneficiaries, including different genders, age groups, ethnic groups, and locations (e.g., urban, and rural) as relevant to the project.

Prior to data collection, Americares staff will review the methodology approach and data collection tools developed by the assessor.

Americares Oversight

To ensure a successful and quality assignment within the timeframe provided, Americares Management Team will:

– Facilitate meetings with the assessors and key project staff, and other stakeholders including the Ministry of Health and the Grand Bassa County Health Team.

– Provide all essential project materials and documents, and aggregate data for the desk review.

– Review and provide feedback on documents from the assessor in a timely manner:

o Evaluation methodology and data collection tools

o Final evaluation report with responses to evaluation questions and key recommendations

o Final evaluation presentation

Assessor Tasks

The assessor will lead the exercise working closely with Americares Management Team.

– Write the inception report including finalizing the evaluation methods, research questions and tool(s) and present it to Americares for review.

– Conduct data collection, analysis, report writing, and submission of first draft of the report using an agreed upon template.

– Present findings and recommendations to Americares.

– Finalize the report incorporating feedback and submission of final report.

Deliverables and Timeframe

The timing of the evaluation is expected to start in February 2026, with preparatory activities included, and be completed no later than May 30th 2026, with the delivery of the final report. The assessor is expected to propose a timeline within this timeframe.

Key deliverables:

– Inception report (includes methodology and data collection tools)

– Evaluation report (draft and final)

– Presentation of the report

The evaluation report is not considered final until it is presented to Americares, discussed with the consultant openly, a clear understanding of all conclusions, and any differing views are reached between the firm/consultant and Americares as reflected in the final document.

Required Competencies from the Individual Consultant / Firm

– Advanced university degree (Masters / PhD) in International Development, Social Sciences, or any other related field with a minimum of 5 years of professional in international development and program evaluation.

– Demonstrated experience in assessments and/or evaluations of interventions on WASH, Health, RMNCAH activities.

– Proven experience in quantitative and qualitative data collection, analysis, interpretation, and visualization.

– Previous professional experience in Liberia/Africa is highly desirable.

– Excellent understanding of humanitarian, development, and rural issues.

– Advanced analytical and report writing skills.

– Proven and strong writing English language skills.

– Thorough understanding of different data collection methods.

– Must be based in Liberia.

Application Process

The deadline for submission of applications and hiring an individual consultant /firm is January 29, 2026 at 5:00 PM Liberia time. All applications should include the following:

– Cover Letter stating the assessor’s availability during the evaluation period and updated CVs of the main assessor, including three references with contact details.

– Technical Proposal: Which should include

o brief explanation about the assessor with particular emphasis on previous experience in this kind of work;

o profile of the assessors to be involved in undertaking data analysis and report writing of the evaluation,

o anticipated data analysis and interpretation plan;

o understanding of the TOR and the task to be accomplished,

o proposed methods and approach to conduct the evaluation

o draft work plan for the assignment (data analysis, interpretation and report writing).

– Financial Proposal: Detailed budget that includes the full cost for including data collection, data analysis, interpretation, visualization, software used and report write up.

– One Previous Similar Report, relevant to the scope of work and deliverables indicated above.

– Copy of Firm’s Legal Documents (valid Article of Incorporation, commercial registration, tax clearance…) and firm’s profile.

If you are interested, please submit application to Americares no later than January 29, 2026, to email address: LiberiaProcurement@americares.org with the title “Evaluation of RMNCAH Program” in the subject line