LRPS-2022-9176504 to conduct Social and Behavioural Study: Knowledge, Attitudes, Beliefs and Practices (KABP) on specific child and adolescent care practices

TERMS OF REFERENCE FOR INSTITUTIONAL CONTRACT

 

Title of the assignment

Social and Behavioural Study: Knowledge, Attitudes, Beliefs and Practices (KABP) on specific child and adolescent care practices 

Purpose

The purpose of this study is to synthesize existing/available evidence on the knowledge, attitudes, beliefs and practices of children and adolescents, parents/caregivers, communities, key influencers and service providers on specific child/adolescent survival, development and protective care and services seeking behaviours, identify evidence gap (quantitative and qualitative) and generate evidence to fill the identified gaps.  The study will generate evidence that will inform strategic social and behaviour change communication planning for improved child-care practices, establish baseline to benchmark the monitoring of social and behaviour change in the new Country Programme (CP) 2022-2026 and beyond and the development of key behaviour monitoring framework.

Location

Dhaka, Bangladesh.  Field visits to collect data across the country.

Estimated Duration

7 months upon signing the contract

Reporting to Technical Supervisor of this assignment

Social and Behaviors Change (SBC) Manager, C4D Section

 

1. Background:

UNICEF has been working in Bangladesh for nearly 70 years in helping the government in ensuring that children grow healthy, well nourished, educated, and protected from any forms of violence, neglect, and abuse.  A UNICEF Bangladesh Situation Analysis 2015 reveals that across all age groups of children as well as sectoral areas, there are a multiplicity of inter-linked and intersecting determinants that impede the survival, development, protection, and participation of children and adolescents, particularly from a behaviors and social change perspective. Shortfalls have been noted at the structural or enabling environment level in relation to traditional social norms, gender differentials and unequal power dynamics between the sexes, inadequacy of laws, policies and development strategies and resources among others; as well as supply side barriers such as unavailability of essential inputs/commodities (e.g., adolescent-friendly health and nutrition related information and counselling services; access to information sources/materials and communication supplies including during emergencies), poor quality of service delivery by providers, and high costs for services, where available. A range of demand-side determinants such as inadequate knowledge, myths, misconceptions, unfavorable attitudes, and harmful practices further compound the situation across all outcome areas.

 

Furthermore, the BCO situation analysis (SitAn) of Children 2020 stated that although domestic legislation in Bangladesh, particularly the new Children Act 2013 (amended 2018) now favors children, their status remains deeply rooted in social beliefs, norms, attitudes, and practices (Papavero, 2013). Not every person younger than age 18 is considered a child, which deeply affects the realization of children’s rights. Social perceptions and expectations of childhood continue to vary according to age, gender, social class, wealth, disability, and other factors. More broadly, a relationship exists between the level of implementation of the CRC and the cultural context, such that researchers believe that strengthening the Convention’s implementation will require substantial changes in socio-cultural values regarding children and childhood. The SitAn also noted from another study that, women are among the most vulnerable social groups. It is not just a result of their gender, roles, and responsibilities, but also is a consequence of the discriminatory social norms and practices that continue to operate in many communities. Government policy to empower women through free education is partially effective, but the dominant patriarchal practices of early marriages and dowries discourage women from coming forward.

 

Gender discriminatory norms and practices must address to achieve transformative change. Government policies and programs should be revised to address women’s practical and strategic needs for gender transformation.

 

The current UNICEF Country Programme (2022-2026) was formulated based on the lessons learned from previous years and in alignment to the 8th Five Year Plan and aiming to support achieving national development UNSDCF goals. Social and behaviors Change (SBC)is an integral part of the new Country Programme (CP) and is positioned as both a key cross-cutting component and as a change strategy. Social and behavior Change in the Country Programme using a socio- ecological approach envisions to promote behavioral and social change by engaging with key stakeholders at all levels, strengthening their capacities and confidence and promoting meaningful dialogue and positive actions that contribute to social change. SBC will be implemented and coordinated across the sector programmes and will contribute towards achieving the results of the education, protection, health, nutrition, WASH, and social protection programme. The C4D section will provide technical leadership to the country office and will work very closely and collaboratively with section programmes and their partners to facilitate the conduct study and the use of its findings.

 

Based on key behavioral priorities and results outlined by UNICEF programme sections and in close consultation with section programmes colleagues, specific key behaviors for UNICEF to focus on in the current CP has been identified. The role of the C4D Section as the technical lead for Social and behavior Change in this regard is to create/facilitate at all levels especially at the community, platforms to enhance knowledge, change negative beliefs and attitudes and address harmful social norms and contribute to the adoption of positive child and adolescent care practices by families and communities in close coordination with the different UNICEF section programmes. In essence, the C4D will oversight the design, execution, monitoring tracking and evaluation of programme specific strategic communication strategies/interventions in support of the CP.

 

SBC in the country programme will employ a child centered approach and would seek to converge the SBC interventions across section programmes around the child at the household and community levels. Emphasis will be on creating an environment that enables strategic communication planning, implementation and monitoring to facilitate the adoption of positive behaviors and social and gender norms by care givers and communities, in a holistic manner and enables increased utilization of health services related to Maternal, Newborn, Child and Adolescent.

 

One of the key strategies of C4D in the CP 2022-2026 is evidence informed programming.  In this regard, a Knowledge, Attitude, Beliefs and Practices (KABP) study on specific WASH, Health, Nutrition, Child Protection, and Education to establish evidence (quantitative and qualitative) on the knowledge, attitudes, beliefs and practices of children and adolescents, parents/caregivers, communities, key influencers and service providers on specific child/adolescent survival, development and protective care and services seeking behaviours and to inform social and behaviour change communication strategic planning for improved child care practices; establish baseline to benchmark the monitoring of social and behaviour change in the new Country Programme (CP) 2022-2026 and beyond, and the development of key behaviour monitoring framework is a key intervention.

 

This TOR is aimed at conducting a quantitative/ qualitative behavioral study to establish the Knowledge, Attitudes, Beliefs and Practices (KABP) on key behaviours related to Health, Nutrition, WASH, Child Protection and Education, and the media/channels/networks best work for behavioural change communications. A set of specific key behaviors under each programme section are identified need to be assessed through this study. The specific key behaviors are as below:

 

Prioritized behaviors/childcare practices: Based on key behavioral priorities and results outlined by programme sections and in close consultation with section programmes colleagues, desired behaviors are clearly articulated in the table below.

Health behaviors

Nutrition behaviors

WASH behaviors

1. Children starts vaccination at 6 weeks of age and completed all doses within 16 months by following the EPI schedule[1]
2. Women attended 1st ANC visit on 6th week, completed at least 4 ANC visits during pregnancy
3. Pregnant women seek facility delivery or delivery by Skilled Birth Attendants
4. Parents and care giver of new-born know and practice all essential new-born care[2]
5. Mothers who deliver at home seek post-natal care for mother and new-born within 72 hours
6. Adolescents have access to and utilize have adolescent friendly health services.

 

 

1. Mothers breastfeed their new-born babies within the first hour of life.
2. Babies 0-6 months are exclusively breastfed.
3. Children 6-23 months receive complementary food that meets minimum dietary diversity at recommended minimum meal frequency.
4. Pregnant and lactating women eat enough quantity[3] of food and maintain a balanced diet.
5. Children 0-5 years receive early stimulation and nurturing care.
6. Adolescent girls 10-19 years have access to and consume Iron and Folic Acid supplementation at weekly. 
7. Mothers/caregivers (parents) of malnourished children 0-2 years seek care at SAM facilities

1. Handwashing with soap at critical times [4]
2. Menstrual hygiene practiced by post pubertal adolescent girls.

 

 

Child Protection behaviours

Education behaviours

Social Protection behaviors

1. Parents/caregivers register their children within 45 days of birth.
2. Parents do not marry their girls before age
3. Parents and care givers practice positive discipline and parenting[5].
4. Adolescent in and out seek child protection services when required.

1. Parents are keeping their children in education [6]
2. Parents provide positive supports to their children’s learning  [7]
3. Parents and teachers support boys and girl’s education and learning equally.

 

1. Beneficiaries of cash transfer seek support services when required.

 

 

 2. Purpose and Objectives

The purpose of this study is to generate robust evidence on the knowledge, attitudes, beliefs and practices of children and adolescents, parents/caregivers, communities, key influencers and service providers on specific child/adolescent survival, development and protective care and services seeking behaviours in order to inform the Social and behaviors Change Communication (SBCC) programme design for greater results for children in UNICEF’s new Country Programme 2022-2026, establish baseline on key behaviours of focus and inform the development of a framework for monitoring behaviours change intervention outcomes. Specifically, the study’s objectives are to:

1. Establish the status of KABP of parents, caregivers/communities on the key behaviours of the study focus
2.  Identify the social and behaviour change enablers, inhibiting and reinforcing factors and the relevant factors required to create an enabling environment and responsive policy that address effective communication for behaviour change.
3. Identify the relevant factors required to create an enabling environment and responsive policy that address both demand and supply needs of the key behaviours.
4. Explore the existing opportunities and mechanisms for children, adolescent and community engagement and participation, including the functionality and effectiveness of these opportunities/mechanisms in facilitating community participation and engagement around the key behaviours; and
5. Explore existing communication channels and tools and their reach/effectiveness including identification of “media dark areas”- the areas do not have electricity and availability of conventional media like- Radio, TV, etc.

The study will attempt to answer the following questions among others: What study respondents know or do not know about the key child and adolescent care behaviours of focus

1. The attitude of respondents towards the desirable practices around the key child and adolescent care behaviours of focus
2. The practices of respondents around the key child and adolescent care behaviours of focus
3. The different channels through which respondents receive communication and education of the key behaviours of focus
4. The myths and misconceptions around the key behaviours of focus
5. The prevailing personal normative and collective beliefs around each of the key behaviours (observed pattern of behaviour and analysis)?
6. The interpersonal power plays and gender roles that influences individual and communal beliefs and preferences

1. The preferences and choices of the target group on each of the key behaviours
2. Identify the reasons the target group/communities conform to the pattern of behaviour and determine existence or not of customs, moral rule, descriptive or social norms around each of the key behaviours
3. For each of the key behaviours, identify the existing channel/media, social networks, and reference group.

3. Key ToR tasks:

• Based on initial literature review, develop an inception report that outlines and details plan for the conduct of secondary data analysis including study activities, responsibilities, time schedule, required UNICEF inputs and products
• Conduct a literature review and secondary data analysis of existing evidence on the KABP of the specific focus key behaviours to identify qualitative and quantitative data gaps to inform study design and write report
• Develop field study plan to collect qualitative and quantitative data with detailed field survey activities, responsibilities, time schedule, required inputs, and sample size, selection of the study area(s) and respondents, demographic information, population size.
• Develop a detailed data analysis plan including a description of the possibilities and challenges in terms of data analysis and reporting. The use of a qualitative data analysis software is expected as part of system to be included in the inception report by the researchers, with explanation of how the framework will be built for rigorous qualitative analysis.
• Review and finalize methodologies accordingly, and submit a report outline for approval by the UNICEF
• Develop, finalise the study tools in English using recognized instruments and translate into Bangla language; Pretest and finalize study instrument/tools; Provide copies of the agreed tools/instruments for the training and data collection phase based on the KABP study
• Prepare submission for ethical/IRB approval; obtain ethical/IRB approval and process any other regulatory requirements as outlined in the inception phase
• Identify and train research assistants, and undertake field work, perform data analysis
• Produce draft and final study report including attention to age, sex, geographical, (rural, urban, hard to reach/media dark), and other demographic or vulnerability disaggregation
• Develop a dissemination plan and PowerPoint Presentation, for national divisional level, i.e., summary presentation of key findings and participate in all the dissemination fora

4. Study management:

The study will be jointly managed by UNICEF C4D and SPEAR Sections. SPEAR Section will provide technical support and oversight for quality assurance while C4D Section including field level C4D officers will provide coordination support. The contracted agency will assign one full time research coordinator who will coordinate with UNICEF team. A designated focal point from UNICEF will be responsible for convening, coordinating with all section programme and ensuring timely UNICEF input and feedback.  

5. Methodology:

A mixed methods approach will be employed for this study including qualitative and quantitative methods. The study will be conducted in two phases.  First, would be the literature review and secondary data analysis and synthesis of quantitative and quantitative evidence on knowledge, attitude, beliefs, and practices of study population on the key child and adolescent care practices of study focus, and second phase will focus on a field study to collect data to fill the identified evidence gaps. The agency needs to come up with a proposed mixed methods approach that considers a strong balance between “the numbers and explanations” for answering the study’s purpose and objectives. The agency should also identify expected limitations, risks, and ethical considerations for the assessment.

6. Geographical Location:

The sampling should consider the geographical UNICEF (see annex 1. The sampling size should be representative for generalization of the study findings and should consider every division of Bangladesh (Dhaka, Barisal, Chattogram, Khulna, Mymensingh, Rangpur and Rajshahi), and rural as well as urban, and in hard to reach/media dark locations. 

7. Study Protocol:

The agency will be responsible for generating KABP survey protocols. The protocol will include:

• Study design: The agency will propose the most appropriate design in line with UNICEF’s result framework/theory of change for SBC, which will be subject to review by UNICEF.
• Sampling: The agency will propose the most appropriate sampling. The sample should be representative of the different segments of population and of the respondent types described above. It should consider gender, geographic locations, social exclusion etc.
• Methods of data collection: To include quantitative and qualitative methods demonstrating inclusion of key stakeholders at various levels; including the data collection tools and appropriate qualitative and quantitative methods to be used. It is highly encouraged to adapt innovative approaches using the digital platform for data collection.
• Plan for data analysis: The agency will propose a detailed Data Analysis Plan. The proposal should include insights into how the quantitative and qualitative data will be analyzed and triangulated, how the different sub-groups will be treated in the analysis.
• Budget and study schedule: The agency will be required to provide a detailed budget and timeframe with the submission. A detailed and realistic study schedule/ work plan should be included, indicating timing of activities, results and regular reporting, as required.
• Ethical considerations: The institution/consultant is required to take time to get familiar with UNICEF’s Procedure for ethical standards in Research, Evaluation, Data collection and Analysis

 

 

8.  Deliverables and payment schedule:

Deliverable

Items covered/Included

Timeframe (28 weeks)

Payment schedule

Inception Report

• Develop an inception report with detail study plan that outlines for conduct of secondary data analysis including study activities, responsibilities, time schedule, required UNICEF inputs and products

3 weeks after contract signing

First instalment: 20% upon submission of inception report

Secondary data analysis Report

• Conduct a literature review and secondary data analysis of existing evidence on the KABP of the specific focus key behaviours to identify qualitative and quantitative data gaps to inform study design and write report

5 weeks

Second instalment: 20% upon submission of secondary data analysis report

Detailed data collection and analysis plan including data collection instruments

• Develop a field study plan to fill the qualitative and quantitative evidence gap identified by the secondary data analysis outlining field survey activities, responsibilities, time schedule, sample size, selection of the study area(s) and respondents, demographic information, population size.
• Develop and pre-test data collection tools/instruments and finalize for both quantitative and qualitative part
• Orientation/training completed for the data collectors
• Detailed data analysis plan including challenges to be encountered and reporting
• IRB approval received

6 weeks

Third instalment:  30% upon submission of plan for the conduct of field study to fill the qualitative and quantitative evidence gap identified by the secondary data analysis and outlines

Field data collection progress report (one in middle and another after completion)

• Collection of data both qualitative and quantitative from targeted geographic areas as per samples
• Data quality assurance

8 weeks

 

Comprehensive draft study report and PowerPoint Presentation

• Quantitative and qualitative data fully transcribed and translated
• Data cleaning and data analysis
• Draft a study report based on quant/qual findings and recommendations
• Draft power point presentation on the KABP study
• Receive UNICEF inputs and feedback on draft report

3 weeks

 

 

 

 

 

 

 

 

Final payment: 30% upon submission draft report and approval of final report, PowerPoint Presentation along with all files as mentioned above in section 9

Final study report

• Soft copy of the report incorporating all comments, fully formatted, copy-edited, and finalised to a professional printable standard
• Soft copy of the report ready
• All completed data collection instruments (English and Bangla)
• All raw quantitative and qualitative data (transcripts) and analysis files
• Final Power point presentation

3 weeks post contract-signing

The Agency will coordinate with SBC Manager, as day-to-day basis as and when required. Evaluation Specialist, SPEAR section will provide technical inputs on the data collection tools and report. They will submit reports according to the deliverables and one final report along with other documents as mentioned in the deliverable’s column.

 

9. End products:

Specific output from this assignment will be a comprehensive report of the KABP on the key behaviors of study focus (secondary data analysis and field survey) in electronic and hard copy. The report should clearly distinguish the main findings, conclusions, and recommendations. The findings should be presented on each cluster of behaviors of the different section programmes and should where necessary triangulate quantitative and qualitative data and summarize the findings around knowledge, attitude, behaviors, and the barriers of the desired behaviors. The final report is expected to include the following headings:

• Title page: It will reflect what the study is about. The back page of the title page will include date of publication, names of authors with clear reference to commissioning partners and where the report can be found.
• Preface:  By UNICEF or Chief Investigator based on understanding between parties.
• Content page: Should indicate the sections and annexes for easy reference.
• Acronyms and abbreviations: Explain in full in the first occasion that they are used in the text to assist the reader.
• Acknowledgements: Thank those who have contributed to the study.
• Executive Summary (5 pages max): Summary covering the purpose, context, and coverage of the study (1 paragraph), the methodology (1 paragraph), the main findings, and recommendations may be written in bold or italicized with brief explanatory paragraphs to follow
• Introduction: It will include problem statement or background of the study, its purpose and significance, and structure of the report.
• Conceptual framework: The researchers must add a conceptual framework section where they should define, explain, and clarify the readers the key issues mentioned in the objectives and provide the readers a clear direction about what is going to be done.
• Main findings and conclusions: This will consist of desk review and field findings, aligned with the conceptual framework for the capacity assessment, and conclusive statements.
• Key Recommendations: A set of actionable recommendations for the programme planners and implementers for UNICEF and Implementing Partners
• Annexes: tools (including informed consent), ethical clearance letter, data analysis plan, photographs (if any) etc.

 

10. Payment Schedule

 

• First instalment:  20% upon submission of inception report
• Second instalment: 20% upon submission of secondary data analysis report
• Third instalment:  30% upon submission of plan for the conduct of field study to fill the qualitative and quantitative evidence gap identified by the secondary data analysis and outlines

• Final payment: 30% upon submission draft report and approval of final report, PowerPoint Presentation along with all files as mentioned above in section 9

 

11. Qualification requirement of the company/institution/organization

• Strong understanding of Social and behaviors Change concepts in each of the UNICEF programme areas (Health, Nutrition, WASH, Education, Social Protection and Child Protection among team lead and/or experts on team, with 10+ years of experience working with Social, and behaviors Change C4D interventions/research
• 10 years or more experience in conducting quantitative and qualitative research, with demonstrated skills in a wide range of national level studies
• Experience conducting large scale study/survey for development organizations including government, civil society, and UN agencies at national, sub-national and local levels
• Experience conducting rigorous and large qualitative research, using qualitative data analysis software(s), and preparing raw transcripts into rich, succinct, and conclusive narrative reports
• Background in multi-disciplinary, mixed methods research

• Has skilled data collection resource pool who have at least 5 years of experience, expert understanding on SBC concepts, and excellent communication skills
• Strong analytical and report writing skills in English
• Must be able to work/operate legally in Bangladesh
• Ability to access existing national data (DHS and MICs) will be an added advantage.

 

 

 

Annex-1:

Selection for District for KABP Study

Division

District

Presence of sectoral program or vulnerability (explanations are given below) 

Health1­

Nutrition2

WASH3

CP4
 

Education5

Remark6

Barisal

Pirojpur

 

 

 

 

 

2

Barisal

Patuakhali

 

 

 

 

 

3

Barisal

Bhola

 

 

 

 

 

4

Barisal

Barguna

 

 

 

 

 

2

Barisal

Barisal

 

 

 

 

 

2

Barisal

Jhalakathi

 

 

 

 

 

 

Chittagong

Khagrachhari

 

 

 

 

 

2

Chittagong

Noakhali

 

 

 

 

 

1

Chittagong

Bandarban

 

 

 

 

 

3

Chittagong

Chattogram

 

 

 

 

 

3

Chittagong

Rangamati

 

 

 

 

 

2

Chittagong

Brahamanbaria

 

 

 

 

 

1

Chittagong

Cox's Bazar

 

 

 

 

 

2

Chittagong

Cumilla

 

 

 

 

 

2

Chittagong

Chandpur

 

 

 

 

 

 

Chittagong

Feni

 

 

 

 

 

1

Chittagong

Lakshmipur

 

 

 

 

 

 

Mymensingh

Mymensingh

 

 

 

 

 

3

Mymensingh

Netrakona

 

 

 

 

 

3

Mymensingh

Sherpur

 

 

 

 

 

3

Mymensingh

Jamalpur

 

 

 

 

 

3

Mymensingh

Kishorganj

 

 

 

 

 

1

Dhaka

Manikganj

 

 

 

 

 

2

Dhaka

Dhaka

 

 

 

 

Urban

2

Dhaka

Munshiganj

 

 

 

 

 

1

Dhaka

Rajbari

 

 

 

 

 

 

Dhaka

Madaripur

 

 

 

 

 

1

Dhaka

Narayanganj

 

 

 

 

 

 

Dhaka

Narsingdi

 

 

 

 

 

1

Dhaka

Shariatpur

 

 

 

 

 

2

Dhaka

Faridpur

 

 

 

 

 

2

Dhaka

Tangail

 

 

 

 

 

2

Dhaka

Gopalganj

 

 

 

 

 

2

Dhaka

Gazipur

 

 

 

 

 

1

Khulna

Magura

 

 

 

 

 

1

Khulna

Meherpur

 

 

 

 

 

2

Khulna

Kushtia

 

 

 

 

 

1

Khulna

Bagerhat

 

 

 

 

 

 

Khulna

Narail

E

 

 

 

 

2

Khulna

Chuadanga

 

 

 

 

 

1

Khulna

Satkhira

 

 

 

 

 

3

Khulna

Jhenaidah

 

 

 

 

 

2

Khulna

Khulna

 

 

 

 

 

1

Khulna

Jessore

 

 

 

 

 

2

Rajshahi

Natore

 

 

 

 

 

2

Rajshahi

Chapainawabganj

 

 

 

 

 

3

Rajshahi

Kurigram

 

 

 

 

 

3

Rajshahi

Bogura

 

 

 

 

 

3

Rajshahi

Joypurhat

 

 

 

 

 

1

Rajshahi

Naogaon

 

 

 

 

 

2

Rajshahi

Pabna

 

 

 

 

 

2

Rajshahi

Sirajganj

 

 

 

 

 

3

Rangpur

Kurigram

 

 

 

 

 

3

Rangpur

Panchagarh

 

 

 

 

 

 

Rangpur

Rangpur

 

 

 

 

 

1

Rangpur

Thakurgaon

 

 

 

 

 

1

Rangpur

Dinajpur

 

 

 

 

 

1

Rangpur

Nilphamari

 

 

 

 

 

1

Rangpur

Gaibandha

 

 

 

 

 

 

Rangpur

Lalmonirhat

 

 

 

 

 

3

Sylhet

Habiganj

 

 

 

 

 

1

Sylhet

Sylhet

 

 

 

 

 

2

Sylhet

Maulvibazar

 

 

 

 

 

2

Sylhet

Sunamganj

 

 

 

 

 

3

 

1 Health section programme priority/focus districts - red coloured are equity districts and yellow colours are Tipping district.

2 Nutrition section programme presence/focus districts

3 WASH provided programme presence/focus districts. Coverage of program varies from 1-9 Upazillas, City Corporations and Municipalities

4 Top 20 vulnerable districts of Child Protection Programme focus.

5 Education programme section is national level with specific focus districts based on project commitments.

Note: City Corporations (DNCC, DSCC, GCC, CCC.) have multi-sectoral programs

6 Presence of the sectoral program.