TERMS OF REFERENCE FOR INSTITUTIONAL CONTRACT

Title of the assignment

Developing SBCC materials to support interventions to promote and improve uptake of routine immunization

Purpose

The prospective creative agency is expected to develop context appropriate and relevant SBCC materials through a participatory process and in consultation with relevant stakeholders particularly the target community, and specific in the context of ‘New Normal’ induced by COVID-19 pandemic. The agency will develop materials, which will be used throughout the years as part of ongoing EPI activities.

Location

Dhaka, Bangladesh. 

Estimated Duration

10 months, starting from 15th July 2021 to 15th May 2022

Reporting to Technical Supervisor of this assignment

C4D Specialist

1. Background and rationale:

UNICEF will give emphasis in alignment with the new SDG framework, “zero dose” children those who have the least access to broader health and social services beyond immunization. The communities where zero dose children are clustered, face multiple depravations and are disproportionally impacted by vaccine preventable diseases. UNICEF will work with MOHFW to extend immunization services to regularly reach “zero dose” and under immunized children and communities and to sustain high and equitable immunization coverage nationally and in all districts.

Every year more than 3.3 children are enrolled in the EPI cohort as newborns. There are also considerable number of first-time mothers who need to be equipped with messages on importance of routine immunization and linking them with reminder mechanisms through different interventions. Furthermore, across the country, the MR1‐MR2 dropout rate was 4.5 percent, with almost the same rate in the rural areas (4.4 percent) and the urban areas (5.0 percent). The dropout rates between Penta1 and Penta3 showed a declining trend despite, the number remains higher due to size of the population.

Vaccine confidence in Bangladesh is considered to be very high as Prime Minister Sheikh Hasina received Vaccine Hero Award in 2019 and GAVI Best Performance Award twice in the last one decade.  The crude full vaccination coverage by the age of 23 months at the national level by card, register and history in 2019 is 95.3%. Whereas, 99.7% of the children received BCG in the same year. However, due to locked down induced by COVID-19, vaccination coverage dropped sharply in the country. Though immunization services got the full pick up after initial drop off in coverage of all antigen in April and May 2020 due to COVID-19 pandemic situation and achieved above 90% but there are still large number of missed children for all antigen. Despite vaccination session resume in all sites, still they are barriers for organizing session maintaining physical distancing and IPC procedure regarding COVID-19 pandemic situation, lack of infection prevention materials, arranging hand washing facilities for guardians in all session sites etc.

According to CES 2019 data, among the surveyed children, less than 1 percent did not receive any vaccine. More than one‐third of the mothers reported that there was no vaccine in the centre that left their children unvaccinated. One in every ten mothers/ caregivers don’t believe in vaccination which was being followed by other major causes of left‐out such as mothers/ caregivers didn't know that children should be given vaccine (8.7 percent), and the child was sick, so was not taken to the vaccination centre (8.7 percent).

Global anti vaccine movement using social media. With social media access increasing in Bangladesh, there is a need to keep the message of the benefits of immunization high on the agenda to prevent a growth of vaccine refusal and hesitancy. There had been several study on public perception about COVID-19 vaccine, which reveal that there are considerable vaccine hesitancy regarding adult vaccination, which may have impact on routine EPI. 

EPI with the support from UNICEF has been implementing Social and Behaviors Change Communication (SBCC) Strategy for Improving Routine Immunization and Measles-Rubella (MR) Campaign Coverage, which is a living document developed through a consultative process from grassroots to national level. There had been various materials developed to create demand, adapt the context of the current pandemic, risk communication and address vaccine hesitancy in Bangladesh. Nevertheless, many of the community engagement activities were postponed due to the current pandemic.

2020 has been marked by the unprecedented crisis caused by COVID-19. Though the longer-term trajectory of the pandemic remains uncertain, evidence shows that immunization services in many countries have been disrupted. Millions of people are expected to miss out on immunizations, likely leading to a resurgence of VPDs, further exacerbating existing inequities and putting the most marginalized and poorest communities at greater risk.

In Bangladesh, after the initial cessation of immunization services in majority of outreach sites by health workers in April and May 2020, vaccination started maintaining country’s guideline to minimize risk of COVID-19 transmission.

It was planned to develop and implement SBCC materials and activities after the MR Campaign. This was deferred due to locked down and delayed in MR Vaccination Campaign implementation. Nevertheless, there were specific materials for routine EPI developed and used in the context of COVID to encourage the health workers and promote vaccination centres so that caregivers can bring children and maintain health safety behaviours and feel confident in accessing services.

Despite, postponement at least twice, MR Vaccination campaign has been successfully organized during December 2020 – January 2021. The Campaign produced materials for different participants groups and used multiple media to reach out maximum population including media-dark areas. TV PSAs, Radio jingles, Cartoon strips/books, Stickers, Flyers, Booklets, Posters, Flags, Banners, Billboards, Social Media content, Orientation & Training manuals were woven to organize the communication campaign.

The level of SBCC capacity was also assessed at the institutional level both for national and sub-national organizations implementing EPI activities in urban and rural settings. In order to develop a deeper understanding on the entire EPI process, the on-going assessment also used unstructured observations method at the service delivery points. This helped to scan service environment and interpersonal communication skills of vaccinators. As a result of the above, there is a need to develop interpersonal communication as well as guidelines for the use of immunization SBCC materials for Health Assistants towards addressing the challenges of optimal immunization uptake above, the DGHS has developed a Social and Behaviour Change Communication (SBCC) Strategy for Improving Routine Immunization and Measles-Rubella (MR) Campaign Coverage in 2019. The recent MRV Campaign 2020 had been orgznied based on implementation of the strategy.

This document will guide the assignment of this ToR by the UNICEF hired creative agency.

1. Overall objective, purpose and expected results:

Objective: The overall objective of this assignment is to support achieving EPI targets with a view to ensure coverage for children living in most-hard-to-reach destinations, too-high-to-reach communities, urban poor, ethnic and other marginalized communities.

Purpose: The prospective creative agency is expected to develop context appropriate and relevant SBCC materials through a participatory process and in consultation with relevant stakeholders particularly the target community, and specific in the context of ‘New Normal’ induced by COVID-19 pandemic. The agency will develop materials, which will be used throughout the years as part of ongoing EPI activities.

Expected results: The developed materials are intended to:

• Contribute towards attaining national goals on immunization through Improving demand generation for routine immunization with a specific focus to different audience groups categorized in this ToR and the SBCC Strategy.

• Mobilize and engage communities and individuals through accurate and timely information.
• Mitigate and manage the media impact of potential Adverse Event Following Immunization (AEFIs) and other negative events among the general population and target groups.

1. Description of Assignment

Major Tasks and responsibilities:

End production/ deliverable

Time Frame

1. Preparation of inception report and setting a creative team

• Inception report that outlines:  Background, communication approach/method, detail timeline of each activities, tools/methods, human resources required and its status, quality assurance, risk management, reporting interval, communication modality
• Evidence of appointments and composition of qualified creative team/sub-teams for specific tasks considering interventions.
• Draft action plan

Two weeks from the start date of contract

ii. Discussion with EPI and relevant counterparts and provide briefing on the project cycle along with key milestones.

Detail action plan prepared

One week

iii. Arrange three-day residential workshop with key stakeholders for developing audience specific SBCC interactive activities key messages and outline design of materials.

• Three-days message and material development workshop conducted, outlining the key messages, draft design materials and report submitted
• A tentative list of the materials is given along with this ToR.

Three weeks

iv. Develop, pretest and finalize messages, materials, tools and techniques in Standard Bangla, major dialects (Chittgonian, Sylheti etc.) and ethnic languages following scientific methods and creative intelligences. Submission and received approval from IEC technical committee of MOHFW Participatory approach will be needed to this many of the activities. Partners will include but not limited to MoHFW, Local government institutions including City Corporations, Faith Based Agencies, BGMEA, Bangladesh Tea Association, Islamic Foundation and other faith-based agencies, Little doctor programme, vaccinators and medical professionals, societies in urban areas, media etc.

v. Develop, pretest and finalize user manuals for all the materials and orientation/capacity building packages.

Agency will be responsible to hire/engage an expert team for pretesting in consultation with UNICEF.

vi. Provide support in preparing for, participating and documenting feedback during the IEC Technical Meeting with MoHFW and undertaking measures accordingly.

vii. Support government and other partners in conducting orientation on the materials and users’ manuals.

Partners will include but not limited to: MoHFW, Local government institutions including City Corporations, Faith Based Agencies, BGMEA, Bangladesh Tea Association, Islamic Foundation and other faith-based agencies, Little doctor programme, vaccinators and medical professionals, societies in urban areas, media etc.

ix. Support production and distribution of the materials following UNICEF’s procedures.

x. Support EPI in improving and promoting its social media channels (FaceBook, YouTube etc.)

Development of an online SBCC training package for the front-liners to improve EPI coverage for the Zoom platform.

• A set of draft materials are ready for pre-testing.
• Reports on pretesting of different materials
• Share the draft materials with government and UNICEF, received/incorporated feedback and submission to IEC technical committee
• Received approval IEC technical committee (Minuets of IEC technical committee)
• Submission the final version of print and audio visual materials.
• Reports on participatory process in conducting local/community level workshop/consultation/meeting to develop materials/activities.
• An SBCC training for the EPI front liners and managers, which chapters/sessions on how to use these materials developed.
• Reports on pretesting of the capacity building/orientation packages
• Plan and Report on orientation activities
• SBCC training manual for Zoom platform
• SBCC Material dissemination guideline developed

8 months

xi. Conduct field testing after materials being used in the community level. The agency will develop field testing protocol and conduct exercise. This will be done after the first batch of materials used in the field. If required, the agency will revise the materials according to findings of field-testing

• Submission of field-testing report.
• Submission of revised material design with required changes based on field test findings

xii. Submission of final assignment report along financial statement

Final assignment report outlining the process, outputs, challenges and recommendations

Two weeks

Total:

10 Months

Note: some of the consultancy days will run concurrently

1. Guiding notes for preparing technical and financial proposal:

Bidders for this assignment should consider and factor the following points, which will guide the ratings of submission into their technical and financial proposal.  An agency may consider these as line items for the financial proposal as well.

1. Three-day residential workshop

This can be organized preferably at a location outside Dhaka with 50 participants (Please include venue, food, TA, DSA and other admissible costs for the participants)

1. Community-based workshop/exercise

Organize at least one exercise for developing materials and interventions with each of the following groups, each exercise may take 1-3 days considering the context.

Urban working mothers and caregivers living in slums

• Workshop with garments workers
• Consultation with Business Manufacturers’ Associations, Bangladesh Readymade Garments Association (BGMEA), FBCCI etc. (Facilitating display of Posters & Billboards in/around the factories, including in Tiffin rooms)
• Develop short information session for lunch breaks so that messages can be disseminated
• Session by a ‘Positive Deviants’ in the factory for anchoring story-sharing sessions/discussions on Child Health

Tea garden labours and owners

• Workshop with tea garden labours and community
• Organize consultation meeting with Bangladesh Tea Association
• Interventions for Chaowkidar Babu through interpersonal communication on EPI in tea garden areas.
• Develop materials for male involvement for vaccination at tea garden

Haor and marshy areas

• Two community level workshops (in Sunamganj and a district in Rangpur Division)
• Branding boats with immunization messages.
• Develop ‘Vatiali’ (a music form from riverine locality)
• Develop Bhawaiya (music form from northern Bangladesh) for message dissemination.

Ethnic community

• Community level workshops in CHT with at least 8 ethnic groups
• Develop ethnic leaders (Karbari, Sarder etc.) as the champions for vaccinations
• Developed materials for community/ethnic media for CHT population (at least in 8 languages)
• Pictorial materials in different ethnic groups to be used by the Health Assistants (at least in 8 languages)

Elected representatives

• Organize consultation workshop with the members of parliaments on improving routine EPI coverage
• Develop a briefing page for the representatives of local government institution to share possible ways for improving immunization in their locations.
• Develop a community accountability framework for EPI based on different exercises

Faith based groups

• Workshop with faith-based scholars and representative
• Print material for at least four faith-based groups (Buddhist, Christian, Hindu, Muslim)
• Mike announcement message

Too-high-to-reach communities

• Networking with local societies & clubs and professional associations such as, Bangladesh Medical Association, Bangladesh Pediatrics society.
• Develop materials in English for the too-high-to-reach groups
• Design and 100 Cut-outs for out-door communication

Vaccinators and health service providers

• Workshop with Health Assistants and Volunteers at UP level
• Develop story-telling sessions on ‘My Child’s Health’ at community level – anchored by health assistants and available Positive Deviants in a community.
• Workshop with EPI and partners on Risk Communication material development
• Design a risk communication guideline for the EPI managers
• Development of minimum standard for counseling protocol for the Health Assistants
• Designing a decoration set (including branding) for EPI fixed and satellite centres with can be produced local based on their requirement.
• Develop a training manual for the Health Assistants. The manual will include basics of SBCC and orientation on different approaches mentioned above. This can be dismantled in several sessions each 1-2 hours.

1. Social media and addressing infodemic

• Conduct social media listening and develop a strategy for social media dissemination
• Provide technical support to EPI for enhancing their social media footprints and improving digital communication
• 10 celebrity endorsement videos (each 20-30 secs) developed through candid camera on the promotion of immunization. (These videos will be developed considering the contexts)
• 20-30 Social media static and dynamic posts considering the context
• Involving existing e-platforms (U-Report, Hello News etc.)

1. National and mass media interventions

Please mention unit price for each items e.g. poster, PSA, events etc.

1. Online SBCC Training package

The idea is to develop short sessions, which can be conducted over a certain period based on the content.

1. Payment schedule:

• First payment: 20% on completion of approved inception report
• Second payment: 30% on completion of design, pretesting and final version of print and audio visual materials
• Third payment: 20% on completion of training module, training module pretesting consultation report, On the 4th month based on the deliverables v, vi, vii, viii, ix (but will not accede more than 80% of the total contract)
• Fourth Payment: 20% on completion of field-testing report on used materials and revised design of required materials according to the field findings.
• Fifth  payment:  10% on completion of distribution plan and assignment final report submitting hard-copies and soft-copies of all materials and final report.

1. Reporting and coordination mechanism:

The Agency will coordinate with C4D Specialist and assigned consultant as day-to-day basis as and when required. They will submit three two quarterly report and one final report along with other document as mentioned in the deliverables column. The agency will also closely coordinate with EPI HQ, DHS, MoHFW as needed.

1. Qualifications or Specialized knowledge and work experience required for the assignment:

1. Qualified marketing/advertising/social marketing agency/production house with proven experience of at least 5 years in large scale behaviour change communication in Bangladesh
2. Team leader and key members must have relevant qualification and experiences in relation to SBCC material development, campaign design, electronic and print media, research and evaluation.
3. Team members must have relevant qualification on graphic design, developing high quality creative illustration and relevant intuitional degrees on creative arts/graphic design/social marketing etc.
4. Planning and management and/or in relevant areas of C4D campaigns and particularly work experience immunization programme and supplementary immunization activities.
5. Working experience and familiarity with the health programme of Ministry of Health and Family Welfare, international organization or any other agencies will be an asset.
6. Demonstrated experience of developing strategies and implementing similar campaigns on maternal, newborn and child health issues with GoB or any other agencies.
7. Capable of coming up with innovative ideas and communication solutions and having substantial expertise in using different channels, tools and techniques of mass and community media not limited to but should include:

• Working experience with department of Mass Communication, Bangladesh Betar, Bangladesh Television
• Experienced in print (poster, leaflet, pamphlet, flip chart, story book, banner festoon, roadside decoration etc) 
• Experienced on audio medium (Radio, FM Radio, mike announcement, community radio, song, drama etc.)
• Experienced in audio-visual (Television, Street-side LCD campaign, Electronic billboard etc),
• Expertised in social medial listening and having good understanding on different e-platforms (U-Report, Facebook, YouTube, Instagram, twitter, web stories, Online news portals etc.)
• Having in-depth understanding about developing community lead materials and community engagement activities (courtyard meeting, home visit, dialogue, etc)
• Conversant in local and folk media (Interactive popular theatre, jari, sari, vatialy, kobial, vatialy, pot song, ethnic media etc.)
• Having experience in mobile based interventions (SMC, interactive audio message)
• Experience developing online training materials

1. General conditions: procedures and logistics

Policies both parties should be aware of:

i.         The institutional Contractor will be responsible for all support required to complete the assignment including accommodation, meals, transportation, and tools of trade (including computers).

ii.         Office space will be provided by UNICEF for use during the evaluation and UNICEF premises will be available for the meetings and consultations.

iii.         The institutional Contractor company will not be entitled to the use of UNICEF transportation;

iv.        No contract related activities may commence unless the contract is signed and received by both parties.

vi.        Institutions or their staff will not have supervisory responsibilities or authority on UNICEF budget; and,

Policy both parties should be aware of:

• Members of the contracting company are not entitled to payment of overtime.  All remuneration must be within the contract agreement.
• No contract may commence unless the contract is signed by both UNICEF and the Contractor.
• No member of the contracting company may travel prior to contract signature.
• Members of the Institutional contractor company will not have supervisory responsibilities or authority on UNICEF budget.
• No additional payment request beyond the approved budget will be authorized by UNICEF.