Johns Hopkins Center for Communication Programs

Breakthrough ACTION Project Cameroon

Call for consultants to manage qualitative research of social, cultural, and individual barriers and determinants related to the adoption of key malaria prevention, care-seeking, and treatment behaviors.

Publication date: 20 January 2020

Deadline for submission: 31 January 2020

INTRODUCTION

The Johns Hopkins Center for Communication Programs (CCP), on behalf of the Breakthrough ACTION project, seeks to hire a consultant to conduct qualitative research on malaria prevention, care-seeking, and treatment in the North and Extreme North regions of Cameroon, specifically relevant to children under five years of age and to pregnant women. As described in greater detail below, CCP intends to approach this research with methodologies informed by social and behavior change (SBC), human-centered design, and behavioral economics.

I. CONTEXT OF THE PROGRAM

Breakthrough ACTION is a five-year global project funded by the United States Agency for International Development (USAID). It is designed to build the capacity of organizations in developing countries to design and implement high-level SBC programs. The project is being implemented in several countries under the lead of CCP in collaboration with Save the Children, ideas42, ThinkPlace, and Camber Collective. In Cameroon, Breakthrough ACTION is implemented in the North and Far North Regions.

Malaria remains a serious health problem in Cameroon. Young children (under the age of five) and pregnant women are particularly at risk and contribute to more than 90% of deaths from malaria globally.

In regards to children under five, the identified best practice is that they should be taken for professional consultation within 24 hours of the onset of fever. Once in the health facility, providers should test children (and adults) with fever for malaria using an RDT or microscopy. Only when a malaria case is confirmed should they prescribe antimalarials. The treatment of severe malaria should be reserved for cases of severe malaria. However, relevant research from the 2018 DHS reports that 58.6% and 63.4% of children under five with fever in the past two weeks were taken to a caregiver for consultation and treatment in the Far North and North. Of these, 13.3 and 23.6% were tested for malaria with an RDT or microscopy. Excessive prescribing practices for ACTs and drugs for severe malaria have also been documented.

In regards to pregnant women, intermittent preventive treatment in pregnancy (IPTp) has been identified as an effective and safe method to protect women against malaria during pregnancy. WHO currently recommends 4 doses of Sulfadoxime-Pyremethamine (SP) during pregnancy. However, relevant research from the 2018 DHS indicated that in the Northern region, only 30.3% of pregnant women and only 23.5% of pregnant women in the Far North regions received at least three doses of SP. In fact, only 64.5% (N) and 55.3% (FN) of pregnant women received a first dose. This may be due in part to poor access to health facilities, stock issues, social customs and beliefs or the practices of health care providers. Breakthrough ACTION will explore these barriers, beliefs, norms, and social practices from both the community perspective and the provider’s perspective to try to identify opportunities to increase the percentage of pregnant women receiving the recommended number of doses in the North and Far North Regions of Cameroon.

II. OBJECTIVES OF THE STUDY

The main objective of this study is to identify the social, cultural, and individual determinants of as well as the relationship dynamics between community members, CHWs, and care providers that influence key behaviors for prevention and treatment of malaria among children under the age of five and pregnant women.

The results of this study will be used to:

  1. Provide the Cameroon National Malaria Control Program (NMCP), President’s Malaria Initiative (PMI), and other partner countries with data and information of programmatic use to inform malaria prevention and control programs in the North and Far North regions.

  2. Inform the design of prototypes that will be implemented by Breakthrough ACTION in coordination with PNLP, PMI, and implementing partners to increase adoption of these behaviors.

  3. Strengthen the capacity of the NMCP, regional and community leaders, and local researchers to apply the new study methodologies and tools used in this research.

  4. Contribute to the global knowledge base on how supply side factors and the interaction between health workers and clients shapes the perception, feasibility, adoption, and maintenance of key behaviors against malaria.

III. METHODOLOGY

The design of this research is informed by methodologies used for SBC, human-centered design, and behavioral economics (please see Annex 1, SBC Flow Chart). Data will be collected in urban and rural settings in the North and Far North regions Research participants are expected to include facility-based health workers, community health workers, community members including caregivers of young children and pregnant women, and community leaders. Data collection methods suitable for the research design include interviews, journey mapping, focus group discussions, and observations. A detailed research design will be shared with the selected consultant(s).

The consultant’s duties will include managing field work in one or both of the two regions under the direction of CCP’s Principal Investigator; to ensure the quality of the training, transcripts, and notes from research activities, and to participate in workshops before and after field work organized by the Breakthrough ACTION team with key stakeholders in Yaoundé or Garoua.

IV. TIMELINE

CCP anticipates that the research activities will progress according to the following timeline (provided funding is available). These dates are not final. Please note that CCP expects the consultant to actively participate in each of these activities:

Intent workshop

3 March 2020

Training workshop

5-7 March 2020

Data collection

9-20 March 2020

Insight harvesting workshop

23-25 March 2020

Insights validation workshop

27 March 2020

V. RESPONSIBILITIES

The successful candidate will have experience conducting qualitative research in Cameroon, preferably including qualitative research in the North and Extreme North regions. The successful candidate will be responsible for the following activities:

a) Participate in phone calls with the lead researcher and/or research team from Breakthrough ACTION in preparations for the workshops, training, and field work prior to field work.

b) Review study tools and documents to ensure they are technically sound and appropriate for the local context prior to the training.

c) Before the training, participate in a one-day intent workshop in Yaoundé with stakeholders and partners to establish the intent of this study.

d) Participate in a 3-5-day training workshop that will be organized and facilitated by the Breakthrough ACTION team.

e) Ensure that all key populations are represented at each collection site and participate in the study.

f) Participate in periodic follow-up meetings with the Breakthrough ACTION team and the principal investigator.

g) Obtain the consent of all participants according to the form validated by the ethics committee.

h) Ensure good quality of translations / transcriptions (especially translated transcripts of Fulfulde).

i) Provide all deliverables as indicated below. j) Participate in the 4-day Insights harvesting and validation workshop that will be organized by Breakthrough ACTION project in a residential hotel in Yaoundé

VIII. SELECTION CRITERIA

Candidates will be evaluated based on the following criteria:

  1. Education/formal training as a public health researcher, demographer, sociologist, or anthropologist

  2. Experience leading or conducting qualitative research including focus group discussion and key informant interviews as well as other relevant qualitative research methods. This should include experience synthesizing large amounts of qualitative data to capture important insights.

  3. Experience and training with human centered design or design thinking (preferred, not mandatory)

  4. Familiarity conducting research or working in the North and Far North Regions of Cameroon.

  5. Demonstrated quality of previous published work, including peer reviewed articles or technical reports.

  6. Language proficiency in French and/or English. Proficiency in Fulfulde is a plus.

  7. Quality and availability of at least three references.

This vacancy is archived.

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