Introduction

Oxfam is a rights-based global development organization with more than 70 years of experience in more than 90 countries worldwide. Oxfam’s mission is to end the injustice of poverty and inequality through systemic change and the advancement of political, economic, and social rights. Oxfam has been working in Ghana since 1986, managing programs related to food security and livelihoods, universal access to education and healthcare and transparency and accountability in extractive industries (mining, oil, and gas). Oxfam’s experience in Ghana and strong partnerships with government institutions, Ghanaian civil society organizations and NGOs supports the delivery of active and innovative programs and advocacy work seeking to improve the livelihoods of Ghanaians and strengthen citizen accountability.

Oxfam in Ghana is implementing a 7-year, Global Affairs Canada (GAC) funded project entitled “Sexual and Reproductive Health and Rights for Young Women and Adolescent Girls (SRHR)” in Ghana. Overall, the project aims to increase the enjoyment of health-related human rights by the most marginalized and vulnerable women and adolescent girls in Ghana. This goal will be achieved through (1) increased equitable use of health services by diverse groups of women and adolescent girls, (2) improved provision of gender-responsive, inclusive and accountable health services by health care providers for diverse groups of women and adolescent girls, and (3) improved effectiveness of key stakeholders, particularly women and youth rights organizations, to advocate for evidence-based health care policies, accountable legal framework, equitable and inclusive services.

The “Sexual and Reproductive Health and Rights for Young Women and Adolescent Girls (SRHR)” project sits under the accountable governance system change of the country strategy (2021-2028).

The project will be implemented in five regions across three zones of Ghana namely, North East and Northern regions in the Northern zone; Bono East region in the Middle zone; and Central and Greater Accra in the Southern zone. And 8 (eight) Metropolitan, Municipal and District Assemblies (MMDAs) namely, Ashaiman, Kasoa, Cape Coast, Techiman, Sene East, Sagnargu, Savelugu and West Mamprusi. Oxfam in Ghana is working with five (5) civil society partners to implement the project in the various regions.

Purpose and Objectives of the Baseline Study

The purpose of the baseline study is to provide gendered quantitative and qualitative analytical information of the status of the stated indicators in relation to Pillar 2 - 1200 Improved provision

of gender-responsive, inclusive and accountable sexual and reproductive health services by providers for diverse groups of YW & AG. The result of the baseline would be set as benchmark against which to assess project progress and effectiveness during implementation and evaluation after completion with attention to the intermediate and immediate outcomes under Pillar 2. The result of the baseline would be used to inform programming of Pillar 2 of the Power to Choose project. The baseline study has the following specific objectives.

Specific Objectives:

The scope of the study will look at the health facilities including the staffing, service users, inclusiveness of services, environment, SRHR training needs and the SRHR services offered to adolescents and youth as well as health providers’ perceptions. The scope of the study will also cover Family Planning services, Emergency Obstetric and Neonatal Care (EmONC) services as well as the health facility responsiveness to Gender Based Violence.

Geographically the scope of the study will cover eight Health facilities across the Northern, Middle and Southern belt of the Power to choose project communities.

The baseline study will adopt a mixed design approach (both quantitative and qualitative in nature), applying methods that are informed by Global Affairs Canada (GAC) result-based management approach, Oxfam’s Feminist Monitoring Evaluation Accountability and Learning, and tips for conducting baseline surveys.

The baseline study will draw information from primary sources in Power to choose healthcare facilities related to Rights-based approach; Knowledge; Inclusive attitudes; Inclusive practices; and Young people. Primary data will be collected using interviews with key stakeholders including District Health Management information systems (DHMIS) officers, Facilities administrators or matrons, Family Planning Division Medical doctor, midwifes and nurses, and Nurse at the Out Patient Department (OPD). The study will also use observation as a means to triangulate the self-reported information (what respondent give) with the actual picture or information. Key informant interview (1) with Ghana Health service Youth Friendly Adolescent corner will also be conducted.

Data Collection Tools

The assessment team will adapt the Sexual and Reproductive Health Facility, Providers and Training Needs Assessment Tools which was developed by the Society of Gynaecologist and Obstetrics of Canada (SOGC) with funding support from Global Affairs Canada for the Power to Choose Project. The tools are meant for collecting data on health care facilities from all eight implementing countries. These tools are designed to collect information on:

• Health facility overview
• Human rights approach
• Family planning:
• Existing services
• Readiness of health facilities to provide services
• Training needs of health service providers
• Clinical mentoring priorities
• Emergency obstetric and neonatal care (EmONC)
• Existing services
• Readiness of health facilities to provide services
• Training needs of health service providers
• Clinical mentoring priorities
• GBV facility responsiveness

Sampling of Facilities

The base line data would be collected from the eight (8) health care facilities targeted for project implementation.  We will collect data from all eight facilities to ensure that the particular needs of each facility is adequately assessed in order to provide the required support for the facility.

Below is the table indicating the selected health facilities and purpose of the selection.

Data collection

The study will adopt Purposive Sampling approach to get the best-fit people who can provide the relevant data for the assessment. We will separate respondents by tool. This will comprise of the District Health Management information systems (DHMIS) officer, Facilities administrators or matrons, Family planning Division, Medical doctor, midwife or a nurses, Nurse at the OPD etc.

For the overview of the health facility tool, we will target 1 person per facility, for a total of 8 respondents.

For the EmONC assessment, we will target 3-4 people who work in EmONC per facility.

For the FP assessment, we will target 3-4 people who work in Family Planning per facility.

For the GBV assessment, we will target 3-4 people who work in gender-based violence per facility.

For an overview of youth friendly services, 1 person at the national level will be interviewed.

The instrument will be coded and deployed into the ODK collect for easy collection and analysis.

Data Analysis and Reporting

The team is expected to design both quantitative and qualitative analysis tool to analyze the data and prepare the final report. Findings of the baseline would be shared with Oxfam in Ghana Power to Choose team for discussing and finalization before submission to Oxfam Quebec MEAL team. The final report will also be shared with partners.

Expected Deliverables

Based on the above expectations, the team is expected to provide the following deliverables:

1. Written methodology (including sampling methods, ethical considerations, possible limitations)
2. Data collection tools
3. Cleaned database (quantitative and qualitative)
4. Report with Limitations, findings and recommendations (including consolidation/synthesis of the results from different sources)
5. Final revised report - number of revisions depend on the quality of the submitted document

Timelines and Expected Number of Days

The role of Oxfam

Oxfam in Ghana will support in the work through the following

Support with data collection tool developed by SOGC with funding support from Global Affairs Canada for the implementation of the Power to Choose Project in all 7 implementing countries. (Documents attached as annexes)

Logistical support: Vehicle and accommodation to all project sites.

The Project team will support in the data collection process and organization of validation workshop.