1. BACKGROUND AND INTRODUCTION
An estimated 76,000 maternal deaths occur globally. Of these deaths, 830 women and girls die daily from preventable causes related to pregnancy and childbirth. Sustainable Development Goal three (SDG 3) speaks to the reduction in the Global Maternal Mortality Ratio from 216 deaths per 100,000 live births to less than 70 deaths per 100,000 live births by 2030. This is a continuation of the decrease in the maternal mortality ratio which was achieved as a part of the Millennium Development Goals.
Regionally, the maternal mortality ratio had decreased by 16.4% between 1990 and 2015, but has unfortunately risen by 15% between 2016 and 2020. Of the 8,300 who died from a pregnancy related cause, 1,300 were from the Caribbean. In response, the Pan American Health Organization has received a commitment from countries within the region to reduce the maternal mortality ratio to less than 30 deaths per 100,000 live births.
The maternal mortality ratio for Jamaica has increased from a low of 87.9 per 100,000 live births in 2015 to 153.5 per 100,000 live births in 2022. Quantitatively, although the absolute number of mothers dying has decreased, the number of live births has also decreased. Indirect maternal deaths, which include deaths from circulatory disease, sickle cell disease and HIV/AIDS, accounted for 37.5% of those recorded for 2022. They occurred mainly in women greater than 34 years old and among those who would have had 4 previous deliveries.
Past campaigns have been targeted towards an increased acceptance of family planning methods in a move to reduce the average parity of women in the fertile age. This has been a success for the most part, as Jamaica has seen a steady decline in the number of births from the beginning of that campaign in the 1970s, with a fertility rate of 1.3 recorded in 2022. However, the fall in the birth rate has not translated into a concurrent decrease in the maternal mortality ratio. In addition, the majority (58.7%) of pregnancies in Jamaica are unplanned. This, as well as the fact that more women are opting to have children later in life, results in an antenatal cohort with an increased likelihood of risk factors that may endanger life during and after pregnancy along with the risks of pregnancy itself.
Most pregnant women access care from trained professionals and attend at least four (4) antenatal clinic visits prior to delivery. Those with identified risk factors are referred to high risk clinics either in primary care or in secondary care. Private physicians who see pregnant women also refer their clients, when needed, to specialist services within the public system. The clients are given a maternal record book at the first visit, which is distributed by the Ministry of Health and Wellness. It constitutes a record of parameters for monitoring throughout the pregnancy and also provides basic information to the expectant mother. The book is updated at each visit and also allows for the input of critical information such as referral to a high risk clinic.
Despite all of these measures, the causes of the maternal deaths that have been recorded over the last decade demonstrate the gap that exists between the sharing of information with the client and the understanding and application of that information by the client during and after the antenatal period. This is reflected when using the delay model in the classification of maternal deaths.
An Antenatal Care and Wellbeing Campaign has to be undertaken in order to understand the reasons for the gap between knowledge and practice among our pregnant women. It is also critical to incorporate the life course approach in crafting the campaign to increase the number of women who plan a pregnancy and thereby improve pregnancy outcomes. Family Planning clinics, antenatal clinics and the ongoing “Know your Numbers” campaign provide ample opportunities for gap analyses and the development and execution of strategies to help reduce maternal morbidity and mortality.
At the end of the antenatal care and wellbeing campaign, it is expected that there will be greater awareness of the risks associated with pregnancy, especially with comorbidities, improvement in the proportion of women who attend 4 or more antenatal clinic visits with first and third trimester screens done, better peripartum outcomes and a reduction in the number of maternal deaths with concurrent decrease in the maternal mortality ratio.
Goal:
Reduction of Jamaica’s Maternal Mortality Ratio by a sufficient percentage annually so as to achieve the target MMR of less than 70 per 100,000 live births by 2030.
Campaign objective:
To develop and disseminate major maternal health messages to encourage early antenatal visits and optimal health for pre-natal, antenatal and postnatal periods of the life course.
Target Audience:
Primary target: women of reproductive age, pregnant women, high risk women, their families, the general public
Secondary target: health care workers in the public and private sectors, faith-based organizations, community organizations.
Overall Objective of the Consultancy
● To develop and implement an antenatal care and wellbeing social marketing campaign to inform and educate key stakeholders and the general public about the importance of prenatal planning, risk factor reduction and risk factor management.
2. SCOPE OF WORK
a. Methodology:
The consultant is expected to work with the MOHW team to develop an antenatal care and wellness campaign and implement the activities.
b. Specific Activities:
The Consultant will be required to:
1. Conduct a gap analysis
2. Develop a social marketing campaign plan
3. Coordinate all communication and knowledge management related activities for the campaign
4. Coordinate the design and development (or updating) of campaign material for electronic, social and print media
5. Plan appropriate mass media, interpersonal communications, social media or special events
6. Document the process, results, lessons learnt and recommendations for future similar communication efforts
7. Convene consultations with stakeholders
8. Coordinate and prepare an implementation plan
9. Collaborate with technical teams in adapting content in different forms appropriate for the dissemination platform (e.g. print, media list, social media and web) consistent with the MOHW’s brand and style
10. Collaborate and actively contribute to the dissemination of the communication products
11. Prepare monthly monitoring reports of the campaign and assessment of the communication tools
12. Design a monitoring and evaluation tool for the campaign’s introduction and implementation
13. Plan and conduct social mobilization, communications and advocacy activities
3. DELIVERABLES
The specific deliverables of the Consultant are:
● Inception report with work plan with Gantt chart completed within four (4) weeks of assumption
● Social marketing campaign plan
● Monthly reports demonstrating successful completion of activities within agreed timelines as per the work plan
○ IEC materials developed
○ Events coordinated
○ Social media activities and other media activities coordinated
● Final report on campaign outcomes, lessons learned and recommendations for future campaigns
● Electronic database of all materials developed for the campaign
4. REMUNERATION
| Deliverable | Due Date | Budget (%) | Review Period | Payment Schedule |
| 1. Inception report with work plan with Gantt chart
|
1 month after start date | 10% | 7 days | 4 weeks after approval |
| 2. Campaign plan | 2 months after start date | 20% | 7 days | 4 weeks after approval |
| 3. Monthly reports x 12 (Months 3-14) | Monthly | 60% | 7 days | 4 weeks after approval |
| 4. Final implementation report and electronic database of campaign materials | 14 months after start date | 10% | 10 days | 4 weeks after approval |
Remuneration for monthly reports will be in the form of equal monthly installments, upon submitting a monthly report detailing progress of deliverables as per approved Work Plan and invoice.
Approval of deliverables is based on the quality of the submitted products as determined by the Director, Family Health Unit and the Campaign Technical Working Group (Public Relations & Communications and Health Promotion & Education Units, Regions, Private Sector).
5. CONSULTANCY DURATION AND TYPE
Type of assignment: Services contract – firm
Duration and probable dates: 15 months
6. REPORTING RELATIONSHIP
Report to the Director, Family Health Unit.
Liaison with Director, PR & Communications and Director, Health Promotion & Education
7. FUNDING
The Ministry of Health and Wellness will fund the consultancy.
8. SPECIFIC INPUTS
The Ministry of Health and Wellness, through the Family Health Unit and Campaign TWG, will:
– Provide requested internal reference documents to enable the consultant to complete assigned tasks under the objectives and scope of work of the Terms of Reference
– Facilitate consultations with stakeholders/experts
– Provide written feedback on updated and newly developed information, education and communication (IEC) material
– Procure all goods and services required to carry out communications related tasks, including material design, product development and placement
9. REQUIRED QUALIFICATIONS/ REQUIREMENTS
The lead consultant should have the following requirements:
– Bachelor’s Degree in Communications, Journalism or Equivalent.
– Minimum 5 years working experience in Public Relations/Communication or the Media.
– Technical expertise and proven skills in the design, planning and implementation of strategies and communication campaigns
– Expertise in the development and conceptualization of multimedia contents
– Excellent organizational and analytical skills combined with excellent communication and interpersonal skills
– Strong professional oral and writing skills, including the development of reports, oral presentations and persuasive documents for consideration at the highest level of the organization
– Demonstrated experience working with multi-disciplinary teams.
10. EVALUATION CRITERIA
Applicants will be scored out of 100 upon the presentation of a CV and a detailed technical proposal to determine eligibility. The scores will be awarded as follows:
| Criteria | Maximum Score |
| Qualification:
Bachelor’s Degree in Communications, Journalism or Equivalent (30)
|
30 |
| Experience:
Working experience in Public Relations/Communication or the Media. – At least 5 years (30) OR – Less than 5 years (15) |
30 |
| Technical Proposal:
– Detailed technical methodology (20) – Detailed work plan (20) |
40 |
A minimum score of 70 is required for shortlisting of candidates for interviews. The consultant with the highest ranked interview score would then be invited to submit a financial proposal for review against the estimate; and for negotiation.
11. SPECIAL TERMS AND CONDITIONS
The Consultant works at his/her own pace but must meet the established deadlines. All expenses excluding those procured by the MOHW (refer to Section 7 above) should be stated in the budget as the total in the proposal is the final amount to be paid. All resources and documentation produced from this activity are owned by the Ministry of Health and Wellness and shall not be accessed, shared or published without the permission of the Ministry of Health and Wellness.