Service contract for endline population-based representative survey on menstrual

I. GENERAL FRAMEWORK OF REFERENCE

1.1 Background

Fòs Feminista is an intersectional feminist organization centred around the sexual and reproductive rights and needs of women, girls, and gender-diverse people. Led and governed by the Global South, Fòs Feminista works as an alliance of organizations in 40+ countries worldwide to advance sexual and reproductive health, rights, and justice. Fòs Feminista is both the connective tissue that links these diverse partners in an alliance and an active participant in the broader ecosystem of actors working on sexual and reproductive health, rights, and justice (SRHRJ). Fòs Feminista orchestrates transnational and transregional action by connecting partners throughout the SRHRJ ecosystem, amplifying innovative partner-led solutions to SRHRJ issues, and catalysing funding and political will for an intersectional feminist agenda on SRHRJ.

We recognize that the ability of women, girls, and gender-diverse people to make free and informed choices about their sexual and reproductive lives, including to access safe and legal abortion, is central to their life plans and to achieving gender and reproductive justice. Together with partners in the Alliance, we provide access to sexual and reproductive health care and services, including contraception, abortion, and care for victims of gender-based violence, and we reach young people with comprehensive sexuality education. We are at the forefront of advocating for sexual and reproductive health, rights, and justice from an intersectional lens in national, regional, and global spaces, coordinating with our partners to ensure that diverse experiences, priorities, and voices of the Global South are represented in these spaces. We also strengthen intersectional feminist movements and organizations by creating and holding space for partners to participate in an international community built on feminist values of sharing power, diversity, mutual learning, and solidarity and to access resources to strengthen their work.

Fòs Feminista is leading the Sang pour Sang consortium project to challenge the structural drivers of menstrual discrimination in nine countries in Sub-Saharan Africa, Asia, and the Caribbean so that women, girls, and gender-diverse individuals have the information, services, products, infrastructure, and supporting environment to exercise their right to menstruate with dignity.

Sang pour Sang is a consortium project of four international organisations. The project is funded by AFD (Agence Française de Développement) and has a duration of three years.

II. SCOPE OF WORK

2.1 Objective & Role of the Consultancy

The main objective of this consultancy is to design, conduct, and analyse the results of an endline population-based representative survey to measure changes from baseline in the structural factors of menstrual discrimination experienced by menstruators in the nine Sang pour Sang project countries: Benin, Cameroon, Côte d'Ivoire, Dominican Republic, Guinea, Haiti, Nigeria, Pakistan, and the Philippines.

The endline population-based survey will replicate the baseline survey of menstruators methodology as closely as possible to ensure comparability of results over time, including consistency in the sampling approach, survey instrument, indicator definitions and calculations, data collection procedures, and analytical methods. Any necessary methodological changes will be agreed upon with Fòs Feminista, documented, and assessed during a pilot phase to assess their potential implications for comparability.

The consultant will ensure a representative sample of the target population of menstruators in each country that is comparable to the baseline sample. In addition, the consultant will include a targeted sample of approximately 450 systematically excluded menstruators, approximately 50 per country, using selection criteria and survey approaches consistent with the baseline to ensure inclusivity.

To maximize comparability with the baseline population-based survey of menstruators, the consultant will use the same or similar local survey partners and fieldwork networks where feasible. This will support the consultant in maintaining survey implementation procedures that are as consistent as possible with the baseline population-based survey.

Required Endline Indicators

The primary outcome of interest for the endline population-based survey is the prevalence of menstrual discrimination among menstruators. This outcome will be measured as the percentage of surveyed menstruators who report experiencing at least one restriction on regular activities during their last menstrual period and/or being teased about their menstrual period in the previous six months.

The endline survey must also measure a set of key secondary outcomes aligned with core components of the Sang pour Sang project’s logical framework.

The following indicators are required to measure the priority primary and secondary outcomes:

Primary Outcome Indicator:

Domain: Menstrual Health and Dignity Impacts

• % of menstruators who report menstrual discrimination

• % of menstruators whose participation in regular daily activities was restricted by their last period

• Factors that facilitated or prevented participation in regular activities during menstruation

• % of menstruators who experienced teasing related to menstruation in the last six months

• % who experienced teasing from men and boys

Key Secondary Outcome Indicators:

Domain: Knowledge and Awareness:

• % of menstruators who are aware of more than 1 type of menstrual product

Domain: Product Use and Preference

• % of menstruators using purposely-made menstrual products from local social and solidarity enterprises (SSEs)

Domain: Access to Menstrual Products

• % of menstruators who report that their preferred menstrual product is available and affordable

• $US in monthly cost per menstruator using menstrual products

The endline survey must also measure the following supplementary indicators on important project domains and compare results against baseline:

Domain: Knowledge and Awareness:

• % of menstruators with correct knowledge of the fertile period during the ovulatory cycle

• % of menstruators who know how often to change menstrual products

• % of individuals with knowledge of menopause

Domain: Menstrual Attitudes

• % of menstruators who believe menstruation is dirty or impure

• % of menstruators who think menstruation should be discussed openly with everyone

• % of menstruators who believe that women are inferior to men because they menstruate

• % of menstruators who feel proud to menstruate

Domain: Supportive Environment and Behaviors

• % of menstruators who believe that others in their community think that menstruation is dirty or impure

• % of menstruators who feel confident that they have the skills to manage their menstruation

• % of menstruators who would feel comfortable seeking help for menstrual problems from a health-care provider

• % of menstruators who report that they were able to reduce their menstrual (abdominal/back/cramping) pain when they needed to during their last menstrual period.

• % of menstruators who have someone they feel comfortable asking for support (advice, resources, emotional support) regarding menstruation

Domain: WASH

• % of menstruators who had a space that was clean, private, and where they feel safe to change their menstrual materials during their last menstrual period

• % of menstruators who have consistent access to water for washing during menstruation

• % of menstruators who have hygienic options for disposal of used menstrual products

Domain: Access to Menstrual Products

• % of menstruators who experienced barriers in having their need for menstrual products/materials met

• % of menstruators that used menstrual products during their last period, by type

• % of menstruators who are satisfied with their current meth