Nafasi ya kazi :- Improving access to quality TB services and the lives of drug users in Tanga and Morogoro regions in Tanzania.

1) BACKGROUND

In Tanzania, an estimated tuberculosis incidence rate of 237 cases per 100,000 population was reported in 2019, with 54% (74,067) of cases reported, leaving 62,933 cases of tuberculosis undiagnosed or unreported1. People with diseases that weaken the immune system, such as HIV infection, diabetes mellitus, but also people who use drugs, have a higher risk of becoming infected with TB.

There are an estimated 300,000 drug users in Tanzania, of which 25,000 to 50,000 are identified as injecting drug users2 . According to the same source, the incidence of tuberculosis among drug users is 12 times higher than in the Tanzanian general population. People who use drugs therefore have a high risk of contracting tuberculosis. Risk factors that predispose drug users to TB disease include HIV co-infection, incarceration, inadequate living conditions, frequent homelessness, poor nutrition, alcohol use disorders and smoking, as well as barriers to treatment due to stigmatisation and discrimination. Drug use is criminalised in Tanzania and possession for personal use is a criminal offence. As a result, drug addicts retreat into precarious living conditions to continue their drug use, putting them at increased risk of tuberculosis and/or HIV infection. Police harassment and brutality have been observed and documented in most hotspots3 . In addition, drug addicts do not visit health facilities when they fall ill for fear of breaking the law.

TB disease is caused by mycobacteria. In most cases, these bacteria are transmitted by people with infectious pulmonary tuberculosis through tiny droplets in the air when coughing, speaking or sneezing. The highest risk of infection is with close contact lasting several hours, e.g. in the family, close contacts or in closed, poorly ventilated rooms. After infection, the bacteria are usually suppressed by the body's own defences. If the immune system is weakened, the pathogens become active again long after the initial infection and thus trigger the disease. The use of drugs, living in homelessness, poor nutrition or HIV infections weaken the body's own immune defences. Drug addicts choose to continue their drug use in environments that are difficult for police officers to access, often in enclosed spaces with little natural

In total                  32              6.250                  440              735                102               6.985                 542                 7.527

Based on these evidence, MUKIKUTE and DAHW – German Leprosy Relief Association want to contribute to reducing the burden of tuberculosis among people who use drugs (particularly vulnerable population groups to This project aims to reduce the burden of tuberculosis among people who use drugs by increasing access to community-based, vulnerability-tailored tuberculosis services for and with people who use drugs in Tanga and Morogoro Regions, in close collaboration and partnership with regional and district tuberculosis and leprosy coordinators, community-based organizations, health facilities for medically assisted therapy (MAT) clinics, informal and formal networks of people who use drugs, community-based tuberculosis and leprosy coordinators, and community-based organizations. TO achieve this, MUKIKUTE proposes two core objectives.

1.       5,930 people who use drugs have improved access to client-centred, high-quality and low-threshold TB services by improving the quality of tuberculosis services for and with people who use drugs, in close collaboration with regional and district tuberculosis and leprosy coordinators, health facilities for medically assisted therapy (MAT) clinics, informal and formal networks of people who use drugs, community-based organizations and tuberculosis diagnostic facilities.

2.       Socio-cultural and economic barriers that restrict the access of people who use drugs to tuberculosis services are reduced by introducing drug addicts to appropriate tuberculosis care, helping them to join drug detoxification centres to stop drug abuse, and by forming self-help groups for drug addicts and supporting them with training and seed money for income-generating activities and reintegration into the families

2) OBJECTIVES OF THE CONSULTANCY

The overall objective of this consultancy is to evaluate the project by collecting data on all indicators of the project as described in the results matrix of the project. The evaluation will report changes resulting from the project interventions and outcomes are measured. Beneath are specific tasks that will be required from the selected consultant.

• To collection data for all project indicators as defined by aspects project data and National TB

database.

• To collect, analyze and present evaluation data at the objective, outcome and output level (based on the project impact matrix).
• Moreover, evaluate the results for interventions (1) address key community rights and gender related barriers to services access, (2) capacity building interventions, and (3) livelihood support interventions.
• Project impact matrix to ensure SMART indicators attained to effectively measure project contribution to improving the lives of drug users in Tanzania.
• Provide an overall analysis and recommendations as findings in the implemented project and effective mainstreaming of cross-cutting themes, particularly gender equality and sustainability of interventions.

3) SCOPE

The project covered two regions in the mainland Tanzania and specifically in Morogoro Urban and Tanga Urban Municipalities. MUKIKUTE implemented the project to enhance access to quality TB services and to conduct community-based livelihood interventions for people who use drugs in these municipalities

4) APPROACH AND METHODOLOGY

• The evaluation should adopt a mixed methods approach, integrating quantitative and qualitative methods to ensure that data collected can be communicated, explained and contextualized.
• The Consultant is encouraged to use innovative methods to collect and analyze data.
• The sample size shall be determined in collaboration with MUKIKUTE to ensure a gender aware and statistically relevant representation of the project beneficiaries and stakeholders. Information shall be collected from across specified beneficiaries, partners and stakeholders.
• The consultant shall conduct an extensive desk review of TB interventions in the context of hard to reach populations, project and other related documents and secondary sources.
• All data collected during the evaluation has to be disaggregated by age and gender.

5) EXPECTED DELIVERABLES AND TIMELINES

To complete this task, the consultancy is estimated to take up to a total of 7 calendar days starting on the date of the signing of the contract.

In accordance with the following timetable the consultant will:

•  Produce an inception report to demonstrate how s/he will accomplish the aforementioned tasks in a timely fashion, outlining the baseline study approach (sampling framework, data collection strategy and methodologies, tools, criteria etc.) and workplan for baseline study. The inception report will be due within two (2) calendar days after signing of the contract and its finalization will involve incorporation of feedback from MUKIKUTE;
• Draft baseline report informed by:

o   Field data collection;

o   Analysis of data to establish evaluation for all project indicators;

o   The project results matrix

o   Review impact and sustainability of interventions compared to baseline data collected.

• The draft report will be due within four (4) calendar days after finalization of the inception report and will involve incorporation of feedback from MUKIKUTE project implementation team;
• Presentation of the draft report at a one-day validation workshop where inputs from stakeholders will be collected;
• Submit final evaluation report with feedback from MUKIKUTE and other key stakeholders incorporated. The final report will be finalized 5 days after completion of the validation workshop;

6) SUPERVISION

The consultant will work under the overall supervision of MUKIKUTE Director and under the direct supervision of the Senior Technical Advisor in collaboration with the Project Coordinator, Field Officer and M&E Officer.

The Consultant will be able to benefit from the guidance of the program management unit at DAHW both at locally and in Germany particularly on the design (selection of indicators, questionnaire design etc) and review/quality assurance phase of the assignment.

7) REQUIRED QUALIFICATIONS

The independent Individual Consultant is required to do the assignment using the stipulated assessment criteria. Given that subject-specific knowledge is required, the consultant would need to demonstrate strong technical knowledge and expertise in Tuberculosis. Additionally, the consultant should demonstrate expertise in monitoring, evaluation, statistical analysis, and communication of data with proven experience in conducting research, evaluation and complex data gathering as well as experience working with populations in the different provinces/ districts of the country, and local governance institutions specific. The Consultant should have capability to produce high quality reports in English and interact comfortably with local audiences in Swahili.

Required Skills and Experience

Education:

•  Minimum education of Master’s degree in Public Health and/or related discipline;
• Qualifications, including specialized trainings or certifications on program evaluation and results-based management;

Professional experience:

•  At least 7 years of experience in designing and leading program evaluation in the public sector in a Health context, including on gender equality
• Experience in conducting and managing evaluations of projects is desirable;
• Proven ability to produce high-quality reports and manage diverse perspectives in communications and consultations with relevant stakeholders and beneficiaries;
• Excellent written and spoken English and representational capacities

• Fluency in national language-Swahili

8) PAYMENT SCHEDULE

For services rendered under this agreed ToR, the Client shall pay the Consultant an amount not exceeding Three Thousand Euros (EUR 3,000). The amount is the consultancy fee that includes 5% Withholding tax. This amount has been established based on the understanding that it includes all of the Consultant’s costs and profits as well as any tax obligation that may be imposed on the Consultant.

• First instalment of 40% of the total consultancy fee upon satisfactory submission of a quality inception report validated by MUKIKUTE;
• Second instalment of 40% of the total consultancy fee upon satisfactory submission of a quality first draft report;
• Third instalment of 20% of the total consultancy fee upon satisfactory submission of a quality final report inclusive of feedback collected at a validation workshop and validated by MUKIKUTE.

9) SPECIFICATIONS FOR APPLICATION

1.       Technical proposal outlining:

1.  Conceptual framework (2-3 pages)
2. Detailed methodology (2-3 pages)
3. Work plan (1-2 pages)
4. Explanation of the consultants’ suitability for the assignment (1 page) including names and contacts of three recent professional referees
5. Two examples of previous similar work
6. Names and CVs of individuals or team members proposed, highlighting their experience relevant to this study and their roles in the achievement of the assignment.

2.       Financial proposal:

1. The proposal will include a lump sum cost for the assignment
2. A breakdown of the costs related to all aspects of the consultancy (consultancy fee, travel, meetings and the assignment deliverables).

10) HOW TO APPLY

Deadline for submission –  28 March 2026 – 1600hrs EAT

Interested companies/individuals can submit their technical and financial proposals in hard copies and softcopies in a flash disk to;

Mukikute | Patient Organization-Lusaka Street, Plot Number 61 A & B, House No 18, Tandika Maguruwe, Temeke, Dar es Salaam,

P.O. Box 7695 -Mobile +255 713 765 311, +255 715 013 848,

Email: [email protected] , Web: www.mukikute.or.tz