Back GRAIL PROJECT TECHNICAL REVIEW

1. Introduction

Since 2016, Caritas Internationalis, in collaboration with its national members Caritas Nigeria, Caritas Congo ASBL and Caritas Côte d’Ivoire, as well as with UNAIDS and PEPFAR, has successfully implemented the GRAIL Project[1].

1.1 Purpose of GRAIL

GRAIL projects has been created to reinforce the role of religious leaders as key finders of children potentially living with HIV as well as referrals for proper intervention. It depends on religious leaders of faith communities being trained on pastoral and scientific considerations in HIV pathology and subsequently delivering audience-appropriate HIV and AIDS prevention and stigma reduction messaging to their communities. In addition, these “activated” clergy has served as a bridge between identified health centers and their communities by leading teams of Church Health Advisors (ideally serving or retired health workers and volunteers) who targeted high risk mother and child pairs by tracking immunization status; recurrence of symptoms of communicable diseases like fevers, diarrheal disease, respiratory tract infection and skin infections assisted by screening tools like the Bandason Checklist; and provided or referred for HIV testing and counselling and ART initiation where indicated. Co-morbidities diagnosed in children living with HIV were also managed in the referral health centers.

Furthermore, GRAIL being implemented by national Caritas, such as Caritas Nigeria and Caritas Congo ASBL, reinforced the role of religious Pediatric HIV Champions by supporting community-based Medical Outreaches focused on children 0-15, with special attention to children 0-5 and 5-10. During those Medical Outreaches, Caritas Nigeria, in collaboration with local Church Health Teams, local health facilities and Catholic Relief Services-Nigeria, and Caritas Congo ASBL provided non-invasive medical screening tests for children (malnutrition, febrile illness, Tuberculosis Risk Profiling using Tuberculosis Symptom Checklist, HIV risk profiling using Bandason Tool, etc.) which did not require needle pricks or blood samples; eye examinations for refractive errors and visual defects; and over-the-counter prescriptions for common childhood conditions (flu medicines, therapeutic foods/nutritional supplements, vitamins, work expellers, malaria prophylaxis). Moreover, Caritas Nigeria and Caritas Congo ASBL worked with the staff of the local health facility to ensure referral was completed for children found to have medical conditions that could refer to a suspected case of HIV.

1.2 Objectives

GRAIL have one main objective which is to reduce 10% the treatment gap in the selected countries (Nigeria, Cote d’Ivoire and DRC) via the below activities:

a. Training sessions for Religious leaders to raise awareness and scientific based knowledge on pediatric HIV

b. Religious leaders’ Anti-stigma and discrimination messages and activities in their communities

c. Medical outreaches and medical screening

d. Community and health facility linkage

1.3 Expected outcomes

The outcomes of GRAIL project are:

a. Increase in the number of religious leaders aware of pediatric HIV.

b. Increase in the number of children with access to screening and treatment

c. Reinforcing the health capacity of the health system to identify areas with high pediatric HIV treatment gaps and act upon.

1.4 Results

Over the implementation period in selected remote and hard-to-reach areas of Nigeria[2] and DRC[3], including areas affected by protracted humanitarian crisis, religious leaders reached more than 60,000 women, men and children with age-appropriate HIV messaging, referring over 22,000 children for proper HIV testing in adapted faith-based health facilities. Among them, 150 were diagnosed HIV-positive and put under adapted life-saving treatment.

2. Purpose and Objectives of the TOR

In order to move from a pilot to a proper sustained project approach, UNAIDS and PEPFAR suggested Caritas Internationalis to include a Technical Review of GRAIL within its 2021-2022 Work Plan for the UNAIDS-PEPFAR FBO Initiative.

Such Technical Review, which will be led by Caritas Internationalis with the support of selected CI Member Organizations, an independent consultant and experts from UNAIDS and PEPFAR, should last for about 3 months and should be tested through a renewed pilot following the outcomes of the Technical Review. **

While details related to the content of the Technical Review are not yet defined, few aspects of amelioration could already identified:

· Data gathering and processing;

· Monitoring of referrals;

· Monitoring of stigma reduction activities.

The outcomes of the Technical Review will be used for informing the Narrative Report of Caritas Internationalis to UNAIDS for the UNAIDS-PEPFAR FBO Initiative 2021-2022 as well as for offering a scientific and sustainable basis to future GRAIL activities – in particular those aimed at reducing the pediatric HIV treatment gap through referrals done by religious leaders.

2.1 Tasks

In collaboration with the Head of the Advocacy and Campaign Unit of Caritas Internationalis and the CI Officer in charge of health and HIV, the Consultant will lead the Technical Review of the GRAIL Project by, among others:

· Identifying Caritas internal partners (CI General Secretariat relevant departments and relevant CI Member Organizations);

· Identifying Caritas relevant external partners (UNAIDS, PEPFAR, US Center for Diseases Control, relevant national stakeholders such as NACA and other FBOs involved in the GRAIL Project);

· Finalizing the Concept Paper of the Technical Review;

· Setting up the GRAIL Technical Review Team

· Organizing and leading virtual and in-person interviews and field visits;

· Organizing and leading virtual and in-person meetings of the technical review committee

· Identifying elements of linkage between GRAIL and baby shower model

· Identifying the added value of GRAIL compared to other FBOs activities on pediatric HIV especially those financed by PEPFAR;

· Identifying GRAIL main aspects that need further assessment and amelioration including data comparison to national baseline and retention rates;

· Organizing and leading an in-country pilot following the outcomes of the Technical Review;

· Evaluating the in-country pilot;

· Preparing the final Narrative Report for UNAIDS.

The total number of days for this consultancy is estimated at approximately 55 days as indicated in the Consultant Requisition.

2.2 Timeline and deliverables

The Technical Review is set to happen according to the following calendar:

· By 1 February 2022

· Identification of Caritas internal partners (CI GS department(s), CI MOs);

· Identification of Caritas external partners (UNAIDS, PEPFAR, US Center for Diseases Control, relevant national stakeholders such as NACA and other FBOs involved in the GRAIL Project);

· Hiring of external consultant;

· Identification of the main aspects of GRAIL which need further assessment and amelioration.

· By 1 March 2022

· Finalization of the Concept Paper related to the GRAIL Technical Review

· By 15 April 2022

· GRAIL Technical Review through in-person and virtual interviews as well as in-field visits, including identification of the location for the first renewed GRAIL pilot

· Between 1 and 15 May 2022

· GRAIL renewed pilot

· By 30 May 2022

· Presentation of final findings and Narrative Report to UNAIDS and PEPFAR

The Consultant is expected to be available from February 1st 2022 to 30 May 2022.

The consultancy days should not exceed the number of 55 as follow:

· 5 days for the drafting and finalization of the Concept Paper;

· 10 days for organizing and leading virtual and/or in-person meetings of the GRAIL Technical Review Team;

· 10 days for virtual and/or in-person interviews;

· 10 days for the organization of the pilot;

· 5 days for leading the pilot;

· 5 days for the evaluation of the pilot;

· 10 days for drafting and finalizing the Narrative Report for UNAIDS.

2.3 Reporting Requirements:

1. A comprehensive report (max 20 pages plus annexes) addressing all the Technical Review and covering its objectives, illustrated with concrete examples

2. A summary report (max 5 pages) highlighting the main findings.

2.4 Requirements to a candidate:

The consultant will be selected through transparent recruitment process, based on professional experience and competence.

The consultant must have the following demonstrated experience and competences:

1. Proven experience in evaluating HIV-related multi-country programs, with special focus on pediatric HIV

2. Knowledge of the basic implementation logic of the GRAIL Project is desirable

3. Working experience in Caritas and knowledge of Caritas Confederation work

4. Understanding of Caritas principles and values (including Catholic Social Teaching) and Catholic Church structure and work in general

5. Advanced technical knowledge in evaluation methodologies and techniques

6. Strong qualitative and quantitative data collection, analysis and synthesis skills

7. Excellent English language skills, knowledge of French is desirable

[1] GRAIL stands for Galvanizing Religious Actors for better Identification and Linkage to pediatric HIV. This project, launched in 2017 by Caritas Internationalis with the support of UNAIDS and the U.S. President’s Plan for AIDS Relief (PEPFAR) has been implemented in Republic of Nigeria and Democratic Republic of the Congo in coordination and cooperation with Caritas Nigeria and Caritas Congo ASBL.

[2] South East (Enugu, Ebonyi, Imo, Abia, Riers, Cross River); South West (Edo, Ondi, Oyo, Osun, Ogun, Lagos), North Central (FCT, Kaduna, Nasarawa, Benue) and North East (Adamawa, Taraba, Bauchi, Borno, Yobe). All zones have been selected in consultation with UNAIDS Nigeria and the National Agency for the Control of AIDS considering UNAIDS Priority States, pediatric HIV prevalence and availability of faith-based health facilities.

[3] Kisangani, Ubundu, Banalia and Yangambi. All zones have been selected in consultation with UNAIDS DRC and the Programme Nationale Multisectoriel pour la Lutte contre le SIDA considering UNAIDS Priority States, pediatric HIV prevalence and availability of faith-based health facilities.