Evaluation of Bristol FGM Community Development Work – 2010-2011Tender Brief

0.0 Introduction

The Bristol FGM Community Development Project is a two year project commissioned by NHS Bristol to deliver a community-based prevention approach to female genital mutilation (FGM). It is a pioneering project working with African FGM practising communities living in Bristol to safeguard girls by enabling families and communities to abandon the practice of FGM and to improve sexual and reproductive rights and access to health entitlements.

The project is based on three core principles:

  1. Women’s leadership and empowerment is central to change
  2. Partnership working with individuals and community organisations is more sustainable
  3. Training, mentoring and capacity development is necessary for both individuals and community organisations

1.0Purpose of evaluation

To determine the extent to which the Bristol FGM Community Development project has been successful in achieving better health outcomes for girls and women affected byFGM with respect to the following four specific aims:

  1. Improve the confidence, knowledge, awareness and self-determination of girls and women affected by FGM and enable them to make informed choices and ask for the services they need.
  2. Improve the quality of knowledge and understanding of health professionals around FGM, to promote good practice, accessible resources, information and services and good communication between those professions and the communities affected.
  3. Empower young people with skills, safe space to explore issues pertaining to cultural identity and integration
  4. Effective project management and evaluation

2.0 Context

2.1 NHS Bristol commissioned this project in 2009. NHS Bristol is responsible for local NHS services in Bristol serving its c450,000 population. The focus of NHS Bristol is to improve the quality of services and access to hospital based services, patient choice and the type of care they receive including services closer to people’s homes.

2.2 FORWARD works in partnership with two local organisations to implement the FGM community development work: Refugee Women of Bristol (RWoB) and Platform 51. RWoB focuses on work with adult women from FGM practising communities and the wider community and Platform 51 works with girls and young women. We have a part-time Women’s Coordinator based at RWoB and a sessional Youth Coordinator supported by Platform 51. With respect to youth work, we have also previously partnered with the Somali Development Group and individuals from RWoB.

2.3 The Community Advisory Group is a multi-disciplinary group made up of representatives from NHS Bristol, RWoB, project volunteer Community Health Advocates, Platform 51 and FORWARD. The Group meets approximately four times a year to review progress against project logframe, plan activities and address challenges. The Group is serviced by FORWARD and convened by the Women’s Coordinator.

2.4 FORWARD provides management and capacity building support to the project. On a day to day basis this is provided by Community Programme Coordinator and overall responsibility is provided by Head of UK Programmes and/or Executive Director.

2.5 The project is commissioned by NHS Bristol to 31 March 2012. The project was commissioned for one year in October 2009, a further year in October 2010 and then extended to March 2012. It is not known if the project will be re-commissioned for the year 2012-13.

2.6 FORWARD has been successful in securing funding over three years from July 2011 for the development of the FGM community development work from Lankelly Chase Foundation; the second and third years are dependent on FORWARD identifying match funding.

2.7 A brief history to the project and a summary of key recommendations from the first year evaluation is given in Appendix 1.

3.0 Scope of the evaluation

3.1 The scope of the project evaluation is to determine the extent to which the Bristol FGM Community Development Work has succeeded in realising the aims, overall and specific, of the project and the outputs and activities used. We anticipate that the evaluation of this project with women from FGM practising communities, who have used the outreach or other services, will be undertaken by the evaluator with the support of the Community Health Advocates as part of the on-going community-led aspect of the FGM Community Development work.

In addition, where the project has succeeded, to identify the factors involved and where we have not succeeded, the reasons behind this and recommended actions to address the gap. The evaluation should also consider any unexpected outcomes arising from the project. The period covered by the evaluation is October 2010-September 2011 with reference to first year of the project as appropriate.

The project logframeagreed between NHS Bristol and FORWARD is attached as a separate document and shows aims, intended outcomes and outputs and anticipated actions planned to achieve each specific aim. The aims, outcomes and outputs are shown below:

Specific aim / Outcome / Output
  1. Improve the confidence, knowledge, awareness and self-determination of girls and women affected by FGM and enable them to make informed choices and ask for the services they need.
/
  1. Improve access to high quality information on sexual and reproductive health and rights among communities that practice FGM
/
  • 17 Health Advocates distribute information on women’s sexual and reproductive health among FGM practising communities

  1. Increased knowledge of FGM among communities and greater male engagement
/
  • Training Health Advocates supported in community outreach work
  • Engaging men, religious leaders and community organisations

  1. Stronger collective voice of communities in tackling FGM and its related issues
/
  • Interagency conference to mark Zero Tolerance to FGM Day, based on the theme of ‘families at the centre of achieving zero tolerance to FGM’.
  • Summer campaign forum aimed at raising awareness on FGM among wider communities in Bristol as well as safeguarding girls at risk of FGM during the summer holidays

Specific aim / Outcome / Output
  1. Improve the confidence, knowledge, awareness and self-determination of girls and women affected by FGM and enable them to make informed choices and ask for the services they need. (continued)
/
  1. Improved access to services related to FGM
/
  • Run fortnightly drop-in advice sessions, alongside refugee organisations drop-in services

  1. Improve the quality of knowledge and understanding of health professionals around FGM, to promote good practice, accessible resources, information and services and good communication between those professions and the communities affected.
/
  1. Increased knowledge of FGM among key statutory agencies
/
  • Provide input into the multi-agency FGM awareness training
  • Attend and report to all meeting of Bristol FGM Network
  • Community Advisory Group meets quarterly
  • Recruit at least four more members to the project Advisory Committee, targeting representatives of Gambia, Sierra Leone, Kenyan communities and men from FGM practising communities
  • Disseminate research findings on different forums including February 2011 FGM Zero Tolerance event, June summer campaign, professionals trainings, FGM Network meetings, Advisory Group meetings and community workshops, conferences, promotion events

  1. Empower young people with skills, safe space to explore issues pertaining to cultural identity and integration
/
  1. Young people from FGM practising communities are better informed and empowered to make choices and access services that they need
/
  • Establish a young people’s forum which can advocate for the needs of young people around FGM and sexual health, liaising with appropriate Bristol based youth organisations including schools

  1. Effective project management and evaluation
/
  • Produce a six-month progress report and final report including outputs, outcomes and recommendations on next steps.

4.0 Methodology

4.1 We expect that the methodology with include desktop research, background reading, one to one interviews, observations and focus groups as required.

4.2 We anticipate that the evaluator will interview key project stakeholders including:

  • Women from African FGM practising communities using the services
  • Community Health Advocates
  • Women’s Coordinator
  • Sessional Youth Coordinator
  • NHS Bristol Commissioner
  • Community Advisory Group members
  • FORWARD staff team

4.3 Desktop research including

  • Numbers of beneficiaries
  • Equalities breakdown
  • Number of events
  • Number of advocates
  • Review of written materials produced; events; media coverage
  • Project progress reports
  • Project agreements and plans
  • Evaluation report 2009-10

4.4 International Zero Tolerance to FGM event on 29 February 2012: this is a multi-agency event to coincide with International Zero Tolerance to FGM Day on 6 February, and is organised by FORWARD in partnership with the Community Advisory Group. As part of the evaluation, we expect the consultant to participate and observe the event as it represents a significant element to the work of the project in community-based prevention, partnership development and multi-agency working.We expect that the event will feature in the report as part of overall project evaluation.

5.0 Timeframe and budget

5.1 It is expected that the final evaluation report will be submitted to FORWARD by Friday 9 March 2012 in anticipation of the final meeting of the Community Advisory Group and the fulfilment of our reporting obligations to NHS Bristol before the end of the financial year.

5.2 The timetable for engaging the evaluator is as follows:

Date / Action
Thursday 13 October / Invitation to tender for the evaluation sent out
5pm Tuesday 1 November / Deadline for submission of tenders to FORWARD
Shorlisting of tenders by Monday 31 October
Friday 4 November / Shortlisted consultants informed
Wednesday 16 November / Interviews of shortlisted consultants
Selection of successful evaluator
Notification to successful consultant
Contracts sent out
Week beginning 21 November (date tba) / Evaluation initiation meeting with FORWARD
Contract sign-off
Week beginning 23 January / Mid-evaluation review meeting with FORWARD
Monday 20 February / Draft evaluation report submitted to FORWARD
Friday 9 March / Final report submitted to FORWARD
Friday 16 March / Final report submitted to NHS Bristol by FORWARD

5.3 The budget for the evaluation is £3,000.

5.4 FORWARD will provide contact details of all interviewees and all documents produced by FORWARD and partners for the project.

6.0 Submission of tenders for evaluation work

6.1 Consultants tendering for this work should detail their skills, experience and knowledge with particular reference to the following areas:

  • Experience and knowledge of the evaluation of community-led projects in and with BME communities
  • Understanding and knowledge of Bristol’s diverse local communities
  • Approach to the evaluation
  • Methodology to be used
  • Consultants who are to work on the evaluation – experience, skills, knowledge and qualities
  • Timetable of work
  • Consultancy days and cost

6.3 The cost of the tender should be the final cost of the work.

6.4 Applicants should provide two references from previous evaluation work undertaken.

6.5 Tender documents should be submitted by 5pm on Tuesday 1 November by email and post to Julie Christie-Webb, Head of UK Programmes at FORWARD, Suite 2.1 Chandelier Building, 8 Scrubs Lane, London, NW10 6RB. Julie’s email address is .

6.6 Queries about any aspect of the project evaluation should be directed to Julie or Rita Buhanda, Communities Programme Coordinator at , tel 020 8960 4000

Appendix 1 Background

1.0 The project was originally commissioned by NHS Bristol in October 2009 and re-commissioned in 2010 to run from October 2010 to March 2012. In 2008, FORWARD had undertaken a pioneering peer ethnographic evaluation and research (PEER[1]) study with local women on their attitudes and perceptions towards FGM[2]. The report of the study made the following recommendations:

  1. Engagement with the community and Integration: to include community learning especially English language, information provision, youth services, involvement of male community leaders, structured networking, youth service centres, collaboration, trust building, avoidance of alienating press reporting
  2. Providing a safe space for dialogue and discussion
  3. Raising awareness on FGM and other issues using community champions and reaching men
  4. Health services to include specialist, mental health support, female doctors and interpreters
  5. The FGM Bill and child protection need for bottom-up work without which a policy will be limited in its success

This PEER research highlighted the need to strategically engage with affected communities and to inform health and other services. FORWARD had found that it was important to focus on women and empower mothers to address children’s safeguarding issues. FORWARD was already working in partnership with two organisations: Refugee Women of Bristol and the Somali Resource Centre. It had initiated research and engagement between some FGM practicing communities and NHS Bristol. FORWARD was therefore well placed to take on the NHS Bristol’s brief as it had set some extremely important foundations and links.

1.1 A project evaluation[3] was undertaken at the end of the first year of the project and reported in September 2010. The evaluation was carried out as part of the commissioning requirements of NHS Bristol. The objectives of the evaluation of the project in its first year were defined as follows:

  • To assess and document the impact and achievements of the project in relation to its aims and objectives.
  • To assess the coordination and effectiveness of the project activities and implementation structures.
  • To review the sustainability of the project and outline recommendations for improving overall sustainability and effectiveness of the project.
  • To provide key recommendations for FORWARD and Bristol NHS to help them strengthen the community engagement approach and how to achieve maximum impact in safeguarding girls from FGM in Bristol.
  • To draw lessons from the project that can be considered in designing and implementing follow up projects in Bristol and for future replication in other cities in the UK.

The report made 25 recommendations and highlighted ten as the most important. The recommendations and action plan for implementation were discussed at the Bristol Community Advisory Group at their meeting on 29 September 2010. The ten most important were:

  1. Identify the male community champions/leaders in the Somali and Sudanese communities as well as the unreached communities and seek their involvement in the campaign against FGM.
  1. Give the community male champions/leaders in public fora granting them added legitimacy within their communities in order to facilitate work within their communities.
  1. The roles of the advocates and the outreach workers need to be clearly defined.
  1. Clear pathways need to be agreed for those who receive the various types of training and how they will be incorporated into NHS Bristol’s public health programme
  1. Advocacy training to be developed as part of FORWARD’s future programme
  1. Support systems for health advocates/outreach workers will be critical to ongoing delivery and should be carefully developed and resourced.
  1. The deployment of advocates to be planned to optimise their value to the communities and to NHS Bristol.
  1. The scope and specification of the service for FGM and its related issues to be carried out as a priority and to include what constitutes best health outcomes as determined by women affected by FGM.
  1. NHS Bristol to be more pro-active in ensuring continuity between projects with similar remits, thereby facilitating continued progress amongst a target group
  1. FORWARD to create procedures for handling the demands for the dissemination of information and the associated administrative tasks

1

[1] PEER is an innovative participatory approach to qualitative research; the PEER process enables programmes to engage communities in dialogue, and promotes the voice of marginalised and disadvantaged groups. It is a specialism of Options,

[2] Women’s Experiences, Perceptions and Attitudes on Female Genital Mutilation – The Bristol Peer Study (01/10), Principal Researcher, Dr EimanHussein

[3] Project Evaluation Report: Female Genital Mutilation community development work undertaken by FORWARD and commissioned by NHS Bristol (Claire Short, FORWARD 2010)