TENDER NOTICE: TERMS OF REFERENCE (ToR) – NATIONAL CONSULTANCY
Job Description
MÉDICOS DEL MUNDO | DOCTORS OF THE WORLD
Sierra Leone Country Office
Kathombo II, Makeni Road, Kabala, Koinadugu District
Contact: coord.sierraleona@medicosdelmundo.org
Website: www.medicosdelmundo.org
TERMS OF REFERENCE (ToR) – NATIONAL CONSULTANCY
Qualitative Study on the Context of Abortion & Post-Abortion Care (PAC)
Activity A.2.1 | Project Phase II
- Background and Rationale
This study is commissioned under the overarching project titled: “Improving access to and quality of PHC sexual and reproductive health services, with a special focus on adolescents and women of reproductive age, in the districts of Koinadugu and Falaba, Sierra Leone (Phase II)” funded by the Regional Government of Asturias, Spain.
The project is implemented by Médicos del Mundo (MdM), an international humanitarian organization with 20 years of continuous experience in Sierra Leone, having successfully executed more than 30 projects with a total budget of €8 million, including a comprehensive response deployment during the Ebola epidemic. For the past 15 years, MdM’s strategic operations have focused on the entire Koinadugu District, covering Primary Health Care (PHC), Sexual and Reproductive Health (SRH), Mental Health and Psychosocial Support, institutional strengthening, universal health coverage, community development, WASH, and gender-transformative actions (including the prevention and reporting of gender-based and sexual violence, new masculinities, and behavior change strategies).
Registered nationally with a formal framework agreement with the Ministry of Health (MoH), MdM operates with a robust human rights, gender-focused, anthropological approach. While the broader project addresses structural health facilities across both Koinadugu and Falaba, Activity A.2.1 targets the sensitive and heavily stigmatized context of abortion and post-abortion care (PAC). Utilizing MdM’s extensive ground footprint, institutional trust, and participatory field mechanics, this qualitative research will extract critical evidence to counter the underlying structural causes of maternal morbidity among adolescents and women of reproductive age.
- Objective of the Assignment
The primary objective is to conduct a targeted qualitative study using Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) to map and understand the contextual landscape of abortion and post abortion care in Koinadugu and Falaba Districts. This evidence will directly guide MdM’s primary healthcare adjustments and rights-based advocacy strategies.
Specific Objectives include:
- Identify Barriers to PHC Services: Map socio-cultural, financial, geographical, and institutional obstacles preventing adolescents and adult women from accessing safe post-abortion care (PAC) and modern contraceptives.
- Assess Community Perceptions: Unpack localized social stigmas, religious attitudes, and peer pressures surrounding unintended pregnancies and abortion within traditional structures.
- Examine Healthcare-Seeking Pathways: Track the healthcare pathways navigated by adolescents and women facing unintended pregnancies, evaluating the interaction between traditional practices, informal networks, and formal PHC entries.
- Evaluate Systemic and Facility Gaps: Identify infrastructural and operational bottlenecks within rural Peripheral Health Units (PHUs), focusing on health provider biases, stockouts of essential PAC commodities, and adolescent-friendly delivery gaps.
- Scope of Work and Methodology
The consultant must execute a robust qualitative methodology consisting strictly of Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). Quantitative methodologies are outside the scope of this baseline contextual assignment.
Geographic Sampling & Site Selection Criteria:
To ensure a scientifically valid and operationally balanced assessment, field data collection must cover a mixture of purposefully selected project operational sites and randomly sampled administrative zones. The criteria are structured as follows:
- MdM-Supported Chiefdoms: Targeted chiefdoms where MdM currently actively supports Peripheral Health Units (PHUs) to evaluate ongoing interventions and operational delivery standards.
- Randomized Representation Framework: To secure an unbiased regional baseline, the consultant must randomly select at least five (5) chiefdoms from Koinadugu District and at least four (4) chiefdoms from Falaba District from the exhaustive administrative pools below.
Complete Regional Sampling Pool:
Koinadugu District Chiefdoms (Select ≥ 5 Randomly):
Wara-Wara Yagalla, Wara-Wara Bafodia, Sengbe, Diang, Neini (Nieni), Kasunko-Kakellay, Kamukeh, Gbongobor-Kayaka, Thamiso, Kallian.
Falaba District Chiefdoms (Select ≥ 4 Randomly):
Neya, Nyedu, Kulor-Seradu, Mongo, Seradu, Morifindugu, Delemandugu, Sulima, Kabelia, Folasaba-Kamba, Dembelia Musaia, Dembelia Sikunia, Kamadugu-Yiraia.
Core Methodological Executables:
- Minimum 8 Focus Group Discussions (FGDs): Organized into peer-homogenous clusters to optimize conversational safety and openness (explicitly segmented into adolescent girls aged 15-19, young/adult women of reproductive age, male partners/peers, and Community Health Workers).
- Minimum 12 Key Informant Interviews (KIIs): Conducted one-on-one with structured institutional and community stakeholders (including PHU facility in-charges, midwives, Ministry of Health personnel, Traditional Birth Attendants, DHMT officials, and traditional/faith leaders).
- Ethical Clearances & Safeguarding: Formulate robust operational guidelines for informed consent/assent (for minors), absolute data anonymity, secure digital asset storage, and operational trauma-referral mapping for field teams.
- Thematic Coding: Transcribe, clean, translate into English, and code all qualitative audio records using standard framework synthesis aligned with PHC standards.
- Deliverables and Timeline
The entire assignment must be successfully concluded within a strict timeframe of 6 weeks from contract validation.
| Deliverable | Description | Timeline | Payment % |
| D1: Inception Report | Final methodology, localized sampling matrix, and customized FGD/KII semi-structured guides. | End of Week 1 | 30% |
| D2: Field Completion Report | Synthesis of field deployment, actual study implementation, clean English transcripts, and raw anonymized audio logs where necessary. | End of Week 2 | 30% |
| D3: Draft Study Report | Preliminary narrative analysis mapping thematic access barriers and practical recommendations. Note: MdM maintains a strict 5-working-day review window to return operational feedback. | End of Week 3 | — |
| D4: Final Study Report | Comprehensive validated final report incorporating MdM feedback and actionable policy recommendations. | End of Week 5 | 40% |
- Ownership of Data and Intellectual Property
All primary qualitative assets, including raw audio recordings, field notebooks, localized discussion protocols, intermediate transcripts, coded thematic matrices, and draft or final reports generated throughout this mandate, remain the sole and exclusive intellectual property of Médicos del Mundo (MdM).
The consultant is strictly prohibited from utilizing, reproducing, publishing, or sharing any component of the data or study findings with any external third party without express written confirmation from MdM management. Upon completion of the contract, all copies of datasets must be successfully transferred to MdM, and remnants purged from the consultant’s local networks.
- Required Qualifications and Competencies
- Education: Advanced university degree (Master’s) in Public Health, Reproductive Health, Sociology, Medical Anthropology, or adjacent social science structures.
- Alternative Qualifications: A Bachelor’s degree in a relevant field, combined with demonstrated at least 5-year postgraduate field research and clinical experience in Sierra Leone will be considered.
- Experience: Minimum of 5 years of demonstrable experience steering qualitative research within Sierra Leone. Prior experience navigating highly sensitive reproductive health issues (SRHR) or abortion context is mandatory.
- Contextual Mastery: Documented awareness of Sierra Leone’s National Primary Health Care Policy and the National Strategy on Adolescent Sexual and Reproductive Health.
- Linguistic Assets: Fluency in corporate written/spoken English. Field research facilitators must possess verified conversational fluency in local target languages (Kuranko, Limba, Yalunka, Mandingo, Krio).
- Institutional and Logistics Arrangements
MdM will supply relevant strategic background data, project briefings, and administrative introduction letters addressed to the Ministry of Health, District Health Management Teams (DHMTs), and local Paramount Chiefs.
The consultant maintains absolute independent responsibility for all operational field logistics, including hiring and training local data collectors, field transport across challenging terrain, digital voice recorders, data protection compliance, and translation mechanisms.
- Proposal Submission Procedure
Technical and financial proposals must be submitted within exactly 10 days following the official date of advertisement publication – Closing Date/Time: November 15,2026 at 5:00PM. Late submissions will be systematically excluded from evaluation panels.
Digital Submission Framework:
Complete application packages must be emailed directly to coord.sierraleona@medicosdelmundo.org, with admin.koinadugu@medicosdelmundo.org actively copied. The email subject line must strictly state: “[Applicant Name] – Activity A.2.1 Qualitative SRH Study Koinadugu & Falaba”.
Physical Hand-Delivery Alternative:
Sealed envelopes containing hard-copy bids or encrypted USB flash assets can be hand-delivered directly to:
Médicos del Mundo Country Office
Kathombo II, Makeni Road, Kabala, Koinadugu District, Sierra Leone.
