Consultant for the Evaluation of the Tobacco Cessation Clinics/Services in Mauritius and Rodrigues

Evaluation of the Tobacco Cessation Clinics/Services in Mauritiusand Rodrigues

19 - 27 November 2024

Terms of reference for the Local Consultant

1. Background and Introduction

Tobacco cessation, as one of the essential components of the World Health Organization (WHO) MPOWER (Offer to quit), was implemented as a pilot project in Mauritius in 2011 at the Odette Leal Community Health Centre in Beau-Bassin.Thereafter, tobacco cessation services were offered freely in the five health region through the operation of five (5) Tobacco Cessation Clinics - one in each of the five health regions.Gradually, tobacco cessation services were further extended and as at date, there are 11 official TCCs around the island including one in Rodrigues at Mont-Lubin Community Health Centre.

The last evaluation pertaining to TCC services was conducted in 2016 by a team of WHO to assess quality of service and outcomes of the TCCs in Mauritius as per aligned protocols elaborated by the WHO .Capacity-building of medical and paramedical staff is effected on a twice yearly basis to ensure they have the necessary skills towards deterring consumption of tobacco products.A slight decline has been noted with respect to percentage of smokers in Mauritius from 18.1% in 2021 and 19.4% in 2015 as per subsequent National NCD surveys.

2. Scope

The scope of the project has been revised to include a more in-depth analysis towards effectively reviewing the overall Tobacco Control programme in Mauritius.It is to be noted that TCCs are operational on Saturdays from 09 00 hrsto 11 30 hrs in a majority of health regions to facilitate access for smokers, especially those working.The on-site evaluation and visits to TCCs will be scheduled more so on Saturdays. A review of existing Tobacco Cessation programmes/services that exist in the country (both public and private) including the Prison Pilot Tobacco Cessation pilot project, will inform the situational analysis.

3. Objectives of the evaluation of the TCC services and programmes:

The main objectives of the TCC evaluation exercise are:

- First and foremost, to gauge the effectiveness of the TCC services and programmes offered in Mauritius along both quantitative and qualitative parameters as described above;

The quantitative elements under study would pertain to important indicators highlighted in WHO protocol such as success rates, quit rates, default rates, number of patients registering for the programme.

- To determine the accessibility and utilization and also, integration of TCC services with PHC and other levels of health care;

Other quantitative elements will focus on the existence of effective referral channels such as from NCD clinics, chest clinics, family planning sessions, health screening sessions at educational institutions and workplaces as well as community and social welfare centers .

-To assess quality of the Tobacco Cessation services offered freely across the country through the views, perspectives, personal experiences of key informants including patients’ satisfaction, organisation and health care providers;

- To identify gaps/challenges in service delivery; and

- To formulate recommendations on improving the quality of TCCs care offered; further scaling up of the TCCs.

4. Methodology

A mixed research method will be used to conduct the evaluation.Observational visits, review of relevant documents (i.e. National Tobacco Cessation protocol and guidelines, National Tobacco Control Action Plan and past evaluation reports, etc) and Focus Group Disscusions (FGDs) will be conducted to collect data.

This evaluation will be conducted jointly by the World Health Organization (WHO Regional Office for Africa and WHO Country Office Mauritius) and the Ministry of Health and Wellness.A local consultant will be recruited to carry out the day to day activities of the overall evaluation process.WHO will provide the necessarytechnical assistance and guidance to the local consultant during the overall evaluation exercise which will take place from mid-November 2024 to mid-January 2025.

An evaluation team comprising of the following persons will be set up to conduct the evaluation of the TCCs planned from 19 to 27 November 2024 in the field using the tools developed:

1 Tobacco Technical Expert from WHO AFRO

1Technical Person from WHO Mauritius

1Tobacco Cessation Technical Personfrom MOHW

1Tobacco Control Focal Point from MOHW

1Local Consultant

5.Responsibilities, Tasks and Activities of the local consultant:

The local consultant will undertake the following tasks:

- participate in regular meetings (virtual and in-person) with the AFRO Tobacco Control expert and local tobacco technical team to finalize the concept note for the evaluation of the TCCs services and programme;

- devise the necessary data collection tools including interviewer guide, evaluation questionnaire and other evaluation tool under the guidance of WHO;

-conduct a desk review of existing tobacco cessation programmes/services that exist in the country (both public and private) including the Prison Pilot TCCs project to inform the situational analysis.Literature review should cover existing published documents such as the National Tobacco Cessation Protocol and Guidelines; National Tobacco Control Action Plan; National Integrated NCD Action Plan, National NCD Service Plan and TCCs Evaluation Reports (2014 and 2016) and any other clinical protocols and guidelines;

- prepare workplan (timeline) for visiting TCCs, key-informant interviews, focus-group discussions in consultation with the evaluation team;

-visit selected TCCs in Mauritius to collect data regarding the TCCs programme/services ;

- conduct interviews with the different TCC focal points about the progress made, bottlenecks, opportunities and challenges inherent to the TCC programme in Mauritius

- compile the various qualitative information and analyse same based on agreed thematic areas using the evaluation tool; and

- draft and finalize the evaluation report under the guidance of WHO as per template at annex 1.

6.Timeframe

Theconsultant will work on a full time basis for 40 days over a period of ten weeks starting as from the first week of November 2024 to mid- January 2025 towards the below deliverables and as per timeline.

7. Deliverables

- Finalized TCCs Concept Note (by 12 November 2024)

- Evaluation Tools (including interviewer guide, evaluation questionnaire) (by 15 November2024)

- Desk Review report ( by 15 November 2024)

- Data collection through interviews, Focus Group Discussions, etc with the different TCC focal points to understand progress made, bottlenecks, challenges and opportunities inherent to the TCC program in Mauritius (as from 2nd week of November 2024 onwards)

- Compilation and analysis of various qualitative information based on agreed thematic areas (by

15 December 2024)

- Evaluation of the TCCs (19 to 27 November 2024)

- Internal Debriefing on Findings (10 January 2025)

- Final Evaluation Report (15 January 2025)

- Presentation of recommendations to high level officials of MOHW and WHO (4th week of January 2024)

8. Expertise required

The expertise required is basically an experienced medical officer with a minimum of 5 years experience working in the tobacco cessation.The candidate should demonstrate significant

9. Competencies

Technical knowledge

Communication skills

Ability to analyse data

Report writing skills

10. Language

Proficiency in both written and spoken English and French