Background
Homa Bay is one of the 47 counties of the Republic of Kenya. It is located in the southern part of Nyanza, along the shores of Lake Victoria about 420 km south-west of Nairobi. The County covers an area of 3,180 square km and is comprised of eight sub-counties: Suba North, Suba South, Ndhiwa, Homa Bay Town, Rangwe, Karachuonyo, Kabondo, and Kasipul. There are approximately 1.225[1] million people living in Homa Bay, almost entirely of Luo descent and of Christian faith with small pockets of Muslim communities found mostly in urban centres. Other ethnic groups found in the County include the Abasuba, Abagusil, Kisii, Teso, Banyore, Bukusu and Samia. Because of proximity to Lake Victoria, the people of Homa Bay are primarily fishermen, sand harvesters, quarry miners, Boda Boda riders and small-scale farmers growing maize, sugar cane, millet, potatoes and vegetables. The fish caught in the lake is consumed locally and in the neighboring towns.
Currently, the County’s population is dominated by young people who are dependent on those in the workforce. Three quarters of the population is under 30 years old and about half is under 15 years. About 1 in 4 (26%) people in Homa Bay County is an adolescent aged 10-19. The County’s Strategic Plan recognises the increasing youth population and high unemployment as a threat to development. Furthermore, the County’s demographic trends indicate that the population will continue to grow for several generations. If birth rates were to decline rapidly, however, the age structure of the population would shift and there would be more working-age adults relative to children. Consequently, the County could benefit from what is called the “demographic dividend” – economic growth resulting from increased productivity and greater savings due to a lower number of dependents. Benefits of the demographic dividend could be optimized if accompanied by investments in health and education, and relevant job-creation.
In Homa Bay, there are two significant problems currently facing adolescents and young people, posing a significant barrier for the County to harness the demographic dividend: 1) unintended adolescent pregnancies; and 2) high incidences of HIV and STIs. They can be explained by a wide range of factors, including in particular high levels of violence, abuse, exploitation, neglect and harmful cultural practices aimed at children and adolescents, mainly at girls.
Unintended Adolescent Pregnancies
Adolescent pregnancies and motherhood are major concerns for health and development because of their association with higher morbidity and mortality for both the mother and child and their impact on the education of young mothers. In Homa Bay County, half of the women (20-49 years old) and half of the men (20-54 years old) have had sex by age 16 which is two years sooner than the national average for women and one year sooner than the national average for men. Similar trends exist for marriage where half of the women in the County first marry by age 18 and half of the men by age 24. National average age for first marriage for women and men are 20 and 25, respectively.[2]
According to a MoH and AFIDEP analysis, 33% of girls aged 15-19 years in Homa Bay County have begun childbearing; considerably higher than the national average. Specifically, 2.1% are pregnant with their first child and 31.2% have ever given birth, compared to the national average of 3.4% and 14.7%, respectively. Homa Bay County’s age specific fertility rate for girls aged 15-19 (adolescent birth rate) is 178 births per 1,000 girls; about 2 times higher than the national rate.[3]
Reduction in fertility, mortality rates and general improvement of quality of life are partly dependent on education. Although the County has a high Primary School Net Enrolment Rate of 98 percent, about 4,800 primary school-age children are out of school. The Secondary School Net Enrolment Rate for the County is 58 percent with a large number (45,081) of secondary school-age adolescents out of school. At the national level, the net enrolment at primary and secondary levels is 88 and 47 percent respectively.
HIV and AIDS
According to the Kenya HIV County Profiles of 2018[4], HIV prevalence in Homa Bay is nearly 4.3 times higher than the national prevalence at 20.7% (Kenya HIV Estimates 2018). The HIV prevalence among women in the County is higher (22.1%) than that of men (19.1%), indicating that women are more vulnerable to HIV infection. Homa Bay County contributed to 9.3% of the total number of people living with HIV in Kenya, and is ranked the second highest nationally. By the end of 2017, a total of 138,921 people were living with HIV with 13.7% being young people aged 15-24 years and 1% being children under the age of 15 years. Approximately 420 children and 1907 adults died of AIDS-related conditions.
Child Protection
Children under 18 in Homa Bay County constitute 60.3% of the total population. The birth registration rate is 49.9% against the national average of 60%. About 34% of children aged 5-14 years are engaged in child labour of which approximately 30% are in urban settings and 57% in rural. More than 90% of children aged 2-14 years are subjected to at least one form of violent discipline method by their mothers/caretaker. Fifty one percent of mothers/caretakers in Homa Bay believe that children should be physically punished.
There are 22 Child Care facilities in the entire County. However, there are 6 children offices (Rangwe and Homa Bay Town share an officer whilst Suba North and Suba South share another). The number of orphan and vulnerable children is estimated at 11,069 while the number of street children in Homa Bay County is estimated at 250.
Policy and Legal Framework
Homa Bay County lacks robust policies and legal frameworks to institutionalize various programmes and activities thereby negating the process of service delivery. The policies are necessary in creating a framework of financial mobilization from the County Assembly and offering checks and balances. In addition to the need for stronger policies around child protection, adolescent issues and HIV, efforts should be deployed around social protection, gender mainstreaming and gender based violence.
Objectives of the Analysis
The County Government of Homa Bay and UNICEF are deeply concerned by the situation of adolescents and young people in the County. Coordination of the Child Protection response has been challenging and health and welfare outcomes have not been fully understood. Despite tireless investments and efforts by the Government and partners, including those on the ground, unintended pregnancies, cases of child abuse, child exploitation and new cases of HIV are still strikingly high. Consequently, there are ramifications to the County’s adolescents and young people in terms of psycho social development, school attendance and performance, skills development and employment. For these reasons, UNICEF and the Government are undertaking a situation analysis on the Protection of Adolescents and Young People in the Face of Unintended Pregnancies and HIV in the County of Homa Bay.
Specifically, to:
Identify the root causes of violence, abuse, exploitation, neglect and harmful cultural practices promoting child abuse and two key health related consequences: unintended pregnancies and new HIV infections;
Undertake a critical review of existing policies, regulations, legislations therein at County level that address child, adolescent and young people protection and identify gaps and weaknesses.
Chart the responses and contributions of both government and partners in addressing these problems including provisions of services for survivors of particularly sexual violence and abuse of children and adolescents and also prevention mechanisms/interventions; and
Propose appropriate and pragmatic recommendations (both prevention and response) for programming, policy and legislation to mitigate the negative impact and improve the lives of adolescent and young people in Homa Bay County.
Methodology
The situation analysis will require both qualitative and quantitative research methodologies, including the following:
A two-pronged desk review of current epidemiological estimates and programmatic data on the sexual and reproductive health of adolescents and young people focusing principally on unintended pregnancies and HIV and AIDS; and on the levels of violence, abuse and neglect affecting this population. The desk review will also examine the applicable legal and policy framework on SRH and HIV and AIDS. The purpose of this stage is to clearly illustrate the level and scope of the problems; legal and regulatory framework in place for the provision of SRH and HIV/AIDS services; and present the reality that adolescents and young people face in the County.
Key informant interviews and focus group discussions with adolescents and young people, including pregnant adolescents, adolescent and young mothers, adolescent and young fathers and fathers to be; adolescents and young people most at risk of contracting HIV (sexually exploited, engaged in sex work, injecting drugs and young men having sex with men), adolescents and young people living with HIV and representatives of youth organizations to obtain qualitative data on the vulnerabilities, risks and behaviours associated with violence, abuse, neglect and HIV. This stage of the research will assess the level of knowledge, awareness, education and/or understanding amongst adolescents and young people on SRH accessing of SRH and HIV services. This stage will also dive deeply into the adolescent and young person’s experience through their own lens and identify key areas for more focused programming, policy and legislation and strengthened youth focused outreach and services.
Annual and progress report reviews and In-depth interviews from government services and partner organization present in Homa Bay and conduct stakeholders’ interviews including government services leaders (child protection and SRH/HIV response), partner representatives, community leaders, health care service providers, beach management unit representatives, religious leaders and other relevant stakeholders. This phase will provide data and insight into the availability, types of SRH services and use of services by adolescents and young people, service delivery mapping, the challenges and opportunities for service provision including understanding the barriers in the access of these services and an assessment of the impact of the legal and policy framework on the access to SRH and HIV services, the geographical hotspots for child protection concerns particularly unintended pregnancies and HIV and where best to improve and strengthen the response.
Review of the resource allocation by government and partners for Child Protection, SRH and HIV sectors and utilization.
Collation, triangulation and analysis for final report, including proposed recommendations.
Deliverables
Desk review.
Qualitative analytical report on the findings from focus group discussions held with adolescents and young people.
County Government of Homabay and partner Annual and Progress Reports reviewed and interviews with key stakeholders undertaken.
Draft report, including recommendations to be shared with UNICEF HIV Section Team (for fact checking), and Kisumu Field Office Team, County Government of Homabay and Partners, including young people for comments and finalisation. (Max 30 pages, including 5 page executive summary).
Presentation of the draft report to UNICEF, Partners/Young People and County Government of Homabay by Consultant. (Max 20 slides).
Final Report, incorporating the revisions and feedback from stakeholders. (Max 30 pages including 5 page executive summary).
Proposed Timeframe
It is expected that the duration of this consultancy will last 65 working days
Date
Action
Responsible
October
Briefing from UNICEF and County Government of Homa Bay on scope of the work and vision of expected results; launch of the situation analysis
UNICEF KCO/County Government of Homa Bay
December
Draft report submitted to UNICEF/County Government of Homa Bay/Partners/Young People for review.
Selected Candidate; UNICEF KCO, Gov. of Homa Bay, key stakeholders and youth representatives
January
Presentation of report by Selected Candidate to UNICEF/County Government of Homa Bay/Partners/Young People and collection of comments/inputs and additional data.
Selected Candidate; UNICEF KCO, Gov. of Homa Bay, key stakeholders and youth representatives
February
Incorporation of comments from feedback meeting and submission final report
Selected Candidate
Team Composition and Selection
It is expected that the individual consultant/research team/consultancy firm will have the following skills and experience:
Relevant academic background and training in public health, anthropology, sociology, epidemiology, psychology or other, as appropriate.
Strong technical knowledge in child protection, sexual reproductive health of adolescents and young people and HIV and AIDS within the context of Kenya.
Expertise in targeting the hardest to reach, marginal groups including adolescents and young key populations, the poor, rural populations, fisher communities, Boda Boda Riders etc.
Experience in qualitative and quantitative research methods.
Previous experience working with UNICEF and other UN agencies an asset.
Cultural and gender sensitivity; knowledge of the Luo and/or Abasuba language an asset.
Candidates/Firms are requested to submit CVs, letter of interest expressing why they are best suited for the consultancy and technical proposal (Max 3 pages) on how they will attain the consultancy’s objectives.
Only shortlisted candidates/Firms will be contacted at which time they will be requested to produce a more detailed technical proposal including the budget.
Technical Evaluation Criteria
Technical proposal evaluation criteria will be based on the following:
Overall response, completeness, overall concord between requirements and proposal (10 points)
Experience, overall experience of Candidate/Firm (10 points)
Technical skills, relevance to requirements of analysis (15 points)
Key personnel, team leader and other team members (15 points)
Proposed methodology/time frame (20 points)
Financial proposal (30 points)
Please note that only those consultants/Firms who obtain min 70 points will be short listed and invited for the detailed proposal.
Reporting and Accountability
In consultation with the County Government of Homa Bay and UNICEF Kenya’s Child Protection and HIV Sections, the selected consultants/firm will be directly accountable for the delivery of this consultancy to UNICEF Kenya’s Chief of HIV Section.
Conditions
The consultant is expected to commit fully to this task as per the TOR and adhere to the timeline, subject to changes and revisions by UNICEF KCO team.
The consultant will not have supervisory responsibilities nor authority on UNICEF budget and other resources.
As per UNICEF DFAM policy, payment is made against approved deliverables. No advance payment is allowed unless in exceptional circumstances against bank guarantee, subject to a maximum of 30 per cent of the total contract value in cases where advance purchases, for example for supplies or travel, may be necessary.
