Terms of Reference for a scoping study on WASH and Child Health


Water, sanitation and hygiene (WASH) are the basic foundations of public health. Despite the central role sanitation and hygiene can play in promoting health and save lives over a billion people don’t use improved sanitation and out of those nearly 700 million people practice open defecation – a sanitation facility that ensures hygienic separation of human excreta from immediate human contact.This situation represents a significant and constant barrier to human and economic development, through direct impact on health, as well as broader impacts on poverty.

A study by Child Health Epidemiology Reference Group [CHERG] of WHO and UNICEF published in the Lancet provide estimates of U5 mortality in 2010.The report contains some good news and estimates that 2 million fewer children died in 2010 than in 2000. This still leaves 7.6 million children under-5 dying in 2010, and the world is off-track to meet the MDG4 target of reducing by two-thirds under-5 mortality According to this report in South Asia Pneumonia and Diarrhoea account for 22% and 11 % of child deaths.

The above facts have been validated by a2012 report on Global Burden of Diseases [GBD 2012]. Diarrhoea, Malaria and HIV Aids are one of the three biggest killers of children under five years old and represents 10% of the under-five child disease burden. Between age I and 5 diarrhoea is the 2nd biggest disease burden globally. In the GBD 2012 regions of Sub-Saharan Africa and South Asia Diarrhoea is the 2nd leading cause of death between age I and 5.

In Zambia ,according to a 2010 Water Aid study on Health Systems in Zambia, Diarrhoea is ranked 4th at 18%,after Neonatal causes at 23%, acute respiratory infections at 22% and Malaria at 19%. Diarrhoea and Malaria (Water Aid 2010), seems to have declined between 2001 and 2006 and 2006 to 2009 respectively. Other global studies on child diseases puts WASH-related infections such as diarrheal among the most common causes of illness and death in South Asia and three out of five global hot spots of child deaths located in Asia [china, India and Pakistan].Yet as health systems develop, they are increasingly focused on medical interventions for prevention (vaccines) and cure (oral rehydration sachets (ORS), zinc, antibiotics) of such diseases. This has led to little engagement of the health sector in WASH, often viewed as a largely infrastructure-related issue. WASH agencies, while able to respond to supply-side constraints of WASH provision, are less able to generate demand for sanitation and the accompanying hygiene behaviour change necessary for WASH infrastructure to translate into better health outcomes.

Water Aid Zambia, an international independent organisation dedicated exclusively to the provision of safe domestic water supply, sanitation and hygiene education therefore seeks to engage a consultant to undertake a scoping study on WASH and Child Health. For purposes of its focus, “Child” in this context shall include children up to the age of 18 in line withWaterAid’s Global Advocacy Priority (GAP) 2.

Specific Terms of Reference:

Objectives of the research

Water Aid Zambia seeks to research into policies and practices that cut across and govern child health with special reference to water, sanitation and hygiene. The findings will help determine ways upon which policy and service delivery can be improved through pronounced WASH and health linkages. In detail the research will seek to;

» Establish and describe the current policies and structures that provide for efficient management of child health at the district level in Zambia.

» Demonstrate how these policies cut across various sectors of health, education, environment, and water, sanitation and hygiene.

» Analyse latest (from 2010 – present) public community programmes on Child health in line with the policy practise

» Analyse any on-going community or district level initiatives on improving Child healthpolicy and practise » Present policy gaps on Child health at community and district levels on all the above.

» Point out key opportunities for Water Aid to leverage its work in promoting child health in efforts to link it to water, sanitation and hygiene.

» Identify key stakeholders Water Aid can work with in promoting WASH and child health

Scope of Work:

The selected Consultant will be required to design the study methodology, conduct data collection, analyze the data, write the report and present the findings. The scope of work is comprises of the following:

  • Interested consultants should develop and present a technical and financial proposal addressing these ToRs. The technical proposal should specifically address:

»  A proposed approach or work plan that ensures successful delivery of this study as outlined in the ToRs

»  Demonstrate the consultant’s comprehension of the assignment as detailed in the scope of work and the

expected deliverables contained herein.

» Present a proposed list of literature review materials

» Demonstrate a track record in doing similar work and give a brief background of the consultant/consulting firm making reference to experience and previous work » Demonstrate a fair understanding of the WASH sector challenges and opportunities » Contain complete CVs of each proposed key resource that will participate in delivering this study;

» Gantt charts detailing the proposed duration of each task and the involvement of individuals (and confirmation of their availability) over the life of the assignment

  • Preliminary consultations between the selected Consultant and the Policy and Research Officer to allow for a thorough grasp of the nature and scope of the assignment
  • Present for review and discussion a summary of the information gleaned from consultations with client (WaterAid);
  • Analyze both quantitative and qualitative data that will be captured during collection;
  • Write a comprehensive report of the study findings;
  • Present the findings and incorporate all comments in the final report.


The deliverables are as follows:

»  Technical proposal

»  Inception report (with data collection tools)

»  Draft Report

»  Final report

Requirements for Consultant(s):

The Consultant must have a minimum qualification of a degree in any social science field A post graduate qualification would be an added advantage. He/she should have a proven record of practical research experience and a working knowledge in the health sector and/or social developmental issues.


The study is planned for the period February 16th, 2015 to March 13th, 20l5.Deadline for submission of Financial and Technical proposals is Thursday 12th February 2012 A final report is expected by March 16,2015.

Finances and Payment Terms:

The study has a fixed budget The Consultant will be paid the Consultancy fees as well as per diem when out of station. 50 % upon receipt of Inception report and 50% upon approval of final report.

Proposal Evaluation

The proposals will be evaluated on the basis of the technical merit. The decision of the evaluation team will be communicated to the contact persons detailed in the proposals submitted.

No. evaluation criteria score
1 Comprehension of the assignment and scope of coverage of the TORs 30
2 Approach and Methodology adopted 30
3 Qualification and experience of consultant (s) 15
4 Track record  past experience and previous work as it relates to the assignment 25
Total 100


Supervision and Contacts

The Consultant and his team shall report to the Policy and Research Officer

To apply, send your applications in sealed envelope marked ‘WASH and Child Health” to The Country Representative, Water Aid Zambia, Plot no. 37J, Leopards Lane, Kabulonga, Postnet no 81, P/Bag E891, Lusaka, by 12th February 2015. Or via email to MerinaLungu@wateraid.org and copied to giyanisakala@wateraid.org