Background

The Global Fund to Fight AIDS, Tuberculosis and Malaria, the GF was set up as an international financing institution to increase resources to fight the three diseases namely HIV/AIDS, Tuberculosis and Malaria. Global fund has supported large scale prevention, treatment and care program against the three diseases. The purpose of GF is to attract, manage and disburse resources in public –private partnership that will make sustainable and significant contribution to the reduction of mortality and morbidity caused by the three major diseases and contributing for achievement of millennium development goal Fund. To date, January 2015, worldwide 7.3 million peoples are on ARVs, 12.3 million peoples under DOTS and 450 million bed nets distributed.

Tajikistan is at the early stages of an HIV/AIDS epidemic, with an estimated 14000 people living with HIV by end of 2014. Disease control strategies for HIV/AIDS and TB are guided by the National AIDS Strategic Plan and National TB Control Programme. Key goals of former include reducing the HIV/AIDS epidemic and containing concentrated stage i.e. < 1% of the pregnant women by 2015, as well as improving health status of the people living with HIV. The project aims at providing increased access to HIV/AIDS prevention, treatment and care services and laying the foundation for stabilizing the country’s epidemic.  The current HIV/AIDS project is supporting a variety of service delivery points for IDUs, SWs, MSM and prisoners. It is also the only source of funding for (i) strengthening VCT services in the country, (ii) expanding the program to prevent the transmission of HIV from mother-to-child, (iii) improving the blood safety system to eliminate the risk of HIV transmission by 100%, (iv) and providing with high-quality ARV and opportunistic treatment, care and support.

Targets included in the current grant are in line with the ones set by the National HIV/AIDS Program 2011 - 2015 and considered essential to slow and halt the epidemic in the country.

UNDP is a key partner to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) and is the UN Agency assuming the role of Principal recipient of GF grants in Tajikistan. As Principal recipient for GF, assisting the country to meet its main goals in reducing mortality and morbidity from HIV, TB and Malaria, UNDP Tajikistan Office is responsible for the financial and programmatic management of the GF grant as well as for the procurement of health and non health products. In all areas of implementation, it provides capacity development services to relevant national institutions, sub recipients and implementing partners. Currently, UNDP, as Principal Recipient bears full responsibility for the operational and financial management of 3 grants: HIV/AIDS TFM, Tuberculosis TFM and Malaria TFM. Currently, under TFM grants, UNDP runs the Global Fund total grant of USD 26,609,461.63.

Current situation and response

Prevention of an HIV/AIDS epidemic in Tajikistan is one of the top-priority tasks in the country at the present time. Available evidence indicates that HIV is spreading rapidly in the country. According to the official statistics of the National AIDS Prevention and Control Center (National AIDS Center), the number of HIV+ cases has increased from 2 in 1991 to 6558 in January 2015.  HIV + cases are registered in 66 out of 68 districts of the Republic and the number of mortality cases among HIV positive people is 1238 people (18.9%). The current number of people living with AIDS is 748 (589 men, 159 women). The vast majority of the reported HIV cases are of men (70%) of the age group 15-39. The estimated adult HIV prevalence reached 0.3% as reported by UNAIDS Global AIDS Epidemic Report 2013. In the last couple of years the HIV testing has been scaled up and more HIV cases has been detected among key populations including PWID, Sex workers, prisoners and MSM. According to the epidemiological statistics for 2014, the breakdown of the ways of transmission is as follows: injecting – 48.2%; sexual – 42.8%; unknown -  5.9% and vertical - 3.1%.

Out of all HIV positive cases, 87.9% are registered among people aged 15-49 and 7.7% among children up to 14. 69.9% of cases are registered among men and 30.1% among women. Moreover, during the last few years the number of new HIV + cases both among children under 14 and women have significantly increased. Respectively, in 2007 the number of HIV + cases among children under 14 was 1.6%; women - 19% whereas in 2014 the number among children under 14 is 7.7% and women – 30.1. The first case of HIV + among pregnant women in Tajikistan was registered in 2005, as of December 2014, 168 pregnant women with HIV + was registered in the country.

At present, three TFM grants of the GF are being implemented in the Republic of Tajikistan. The TFM GF HIV grant on “Providing universal access to HIV services and lay the foundation for stabilizing the country’s epidemics” is designed to further boost the national capacities in combating the HIV/AIDS epidemic in the country. The current HIV/AIDS project is supporting a variety of service delivery points for PWID, SWs, MSM and prisoners. It is also the only source of funding for (i) strengthening VCT services in the country, (ii) expanding the program to prevent the transmission of HIV from mother-to-child, (iii) improving the blood safety system to eliminate the risk of HIV transmission by 100%, (iv) and providing with high-quality ARV and opportunistic treatment, care and support.

Round 8 HIV/AIDS project “Strengthening the supportive environment and scaling up prevention, treatment and care to contain HIV epidemic in the Republic of Tajikistan” started in October 2009 and was planned for the period of 5 years (2009-2014). Since October 2013, it has been being implemented as the consolidated Round 8 grant and Transitional Funding Mechanism (TFM) of the GF. This is a two-year Program which is being carried out within the period of 1 October 2013 to 30 September 2015. The TFM GF HIV grant is aimed at increasing the access of key populations to HIV prevention and care services; expansion and strengthening of Voluntary Counselling and Testing services, and post test care and support; ensuring effective national blood safety system and strengthening of the health system that supports scaling up of coordinated HIV, STI, TB and blood safety interventions.

Duties and Responsibilities

The purpose of the Evaluation is to enable the team to assess, determine and report on the HIV project inputs, processes, accomplishments, lessons learned and to make recommendation to National Coordination Committee (NCC) and PR for the next stage of program implementation.

The evaluation should:

  • Examine the implementation process of round 8 and TFM HIV control grants;
  • Evaluate the achievement of set up goals and indicators on quality and quantitative levels;
  • Assess the major problems and constrains faced during the implementation of the HIV grants at various levels including national, country, health facilities and SRs;
  • Assess the relationship among different stakeholders involved in the implementation of HIV project, including NCC, PR and SRs.

After the evaluation, HIV grant will develop a plan of action with respective technical working groups to address the gaps identified based on the recommendation. The NCC and PR will also communicate the evaluation results with respective SRs and government counterparts for their action.

 Based on the principles of relevance, effectiveness, efficiency and sustainability, the objectives of the evaluation are to evaluate the extent of progress, achievement and challenges of the project activities and to formulate recommendations for the new phase of UNDP HIV project.

Specific objectives include the following:

  • UNDP value-added as a Principle Recipient of GF grants and its process, products, services that contribute to effective development results compared to set up goals and objectives; its overall contribution to effective development results affecting beneficiaries’ lives;
  • The impact of the HIV grant on implementation of the National HIV/AIDS Program for 2011-2015;
  • Internal and external factors affecting effectiveness and efficiency of HIV projects,
  • Sustainability strategy, best practices, lessons learnt applied within the framework of implementations of HIV Round 8 and TFM grants;
  • Assessment of the contributing role of UNDP  to formulation and implementation of the national priorities in alignment with national policies including strengthening partnerships with national counterparts and key stakeholders;
  • Assessment of improved capacity of national institutions in implementing, monitoring and evaluating HIV prevention in the country;

 Scope of work

The evaluation will review activities under all objectives of the Round 8 and TFM grants. It will refer to the activities conducted by UNDP as the Principal Recipient of grants and its implementation partners (Sub-Recipients) that have contributed to the achievement of the project outcomes and impact. In particular, the evaluation is expected to appraise significance of effective implementation strategy in the country, needs for quality in further developing/prioritizing HIV prevention programmes with measurable targets, workable lessons learnt and best practices, particularly from the added value of the PR and SRs collaboration; findings; conclusions and recommendations and cover the following specific issues:

  • HIV/AIDS and STI prevention activities among key population (PWID, SW, MSM). Evaluation methodology may include Focus Group Discussions and individual interviews with beneficiaries and implementing partners, and observations during site visits. The evaluators should review the overall progress of UNDP HIV prevention program component for harm reduction and STI treatment of PWID, SW and MSM;
  • HIV/AIDS prevention activities (information sessions, HIV testing, ART, STI, N/SEP programs) among prison inmates (upon getting access to penitentiary system). The evaluator should discuss/talk with project implementers (namely, staff of Chief Department on Execution of Criminal Penalty of Ministry of Justice of the Republic of Tajikistan), interview prison inmates / peer educators about implementing activities as well as to review relevant documentation of penitentiary colonies;
  • HIV/AIDS prevention activities among migrants, migrants’ spouses and vulnerable women, especially living in rural areas. The evaluator should apply appropriate evaluation methodologies to find out the effectiveness and impact of project interventions among migrants, migrants’ spouses and vulnerable women in rural regions. Also the evaluator should conduct individual interviews with staff of the Ministry of Labor, Migration and Employment of Tajikistan and the International Organization for Migration (IOM) in Tajikistan that implement HIV prevention activities among migrant, migrant spouses and vulnerable women;
  • Evaluation of ART programme and treatment adherence countrywide in alignment with new WHO treatment protocol. The evaluator should discuss with healthcare service providers the constraints / challenges in ART as a whole, talk with beneficiaries’ about access and adherence to treatment, and review the driving factors of effectiveness of ART programme in the country;
  • Assessment of SR management strategy by UNDP. The evaluator should review the existing strategy of SR management by UNDP and extent of the strategy effectiveness and shortcomings; provide summary of recommendations and best practices in the context of Tajikistan to further improve SR management; review UNDP partnership and coordination approach in HIV area and its connection with overall country coordination system,  including sectoral coordination, its effectiveness and contribution to resilience of HIV prevalence.

Competencies

Functional Competencies:

  • Proven experience of a minimum of 15 years at the international level, preferably with UN experience. Knowledge and familiarity of the United Nations system, its evaluation and programming processes;
  • Knowledge of UNDP procedures and programme implementation strategies will be an additional advantage;
  • Knowledge of political, cultural and economic situation in Tajikistan or ability to quickly acquire such knowledge is desirable
  • Excellent writing and analytical skills;
  • Ability to meet tight deadlines;
  • Excellent communication, team-building and diplomatic skills to develop partnerships.

 Corporate Competencies:

  • Proven experience of a minimum of 15 years at the international level, preferably with UN experience. Knowledge and familiarity of the United Nations system, its evaluation and programming processes;
  • Knowledge of UNDP procedures and programme implementation strategies will be an additional advantage;
  • Knowledge of political, cultural and economic situation in Tajikistan or ability to quickly acquire such knowledge is desirable;
  • Displays cultural, gender, religion, race, nationality, and age sensitivity and adaptability;
  • Treats all people fairly without favoritism.

Required Skills and Experience

Education:

  • University/Masters degree in public health, social sciences, or medicine/public health or other relevant areas

Experience:

  • At least 5 years of demonstrated working experience in research and analysis in HIV/AIDS programme.

Language:

  • Fluent in English.

Application Procedure

Please follow the link to the Individual Consultant Procurement Notice:

http://www.undp.tj/procurement/panel/uploads/IC_PN_HIV_evaluation_international_consultant.doc