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Terms Of Reference For Water, Sanitation And Hygiene (Wash) And Environmental Impact Assessment In Eight (8) Health Facilities (Hfs) And Fourteen (14) Schools In Mudug Region, Somalia

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Terms Of Reference For Water, Sanitation And Hygiene (Wash) And Environmental Impact Assessment In Eight (8) Health Facilities (Hfs) And Fourteen (14) Schools In Mudug Region, Somalia



Decades of protracted conflict, coupled with natural and climate change related hazards such as drought, cyclone and flooding have increased the Somali population vulnerability to chronic food insecurity, diseases outbreak, malnutrition, and resulted in inadequate access to safe drinking water, sanitation and basic health care services[1].  

Drought has driven food insecurity to crises levels across the country, with losses of livestock, pastureland and food. Drought led to the displacement of an estimated 943,000 people across the country from November 2016 to October 2017. 6.2 million people (corresponding to half of the population in Somalia) are acutely food insecure and in need of urgent life-saving assistance. This, together with a lack of clean drinking water and access to health facilities, are causing rising morbidity and mortality rates and severe long-term impacts on livelihoods and assets. Somalia displays one of the worst infant and young child feeding and micronutrient indicators in the world. As of end of October 2017, over 363,000 children were suffering from acute malnutrition and in need of urgent treatment and nutrition support[2].

Despite the progress that has been made by the Somalia government in re-establishing state structures, there remains a lack of public health service institutions to meet all the humanitarian needs of the population. The SRCS, which was established in 1963, continues to play a significant role in filling the gap in the health service delivery system. SRCS is currently the second largest primary health care service provider in Somalia and operates through a network of 19 branches and 130 sub-branches with activities spread all across the country. With the support of Red Cross Red Crescent Movement (RCRC Movement) partners, SRCS has been running over 150 health clinics, stationary (100) and mobile (50) clinics. SRCS works in close cooperation with the Federal Ministry of Health, the Ministries of Health of the Federal Member States and other health actors, with the aim of the governments, with time, taking over more of the health services.

While Norcross started working with SRCS since the early sixties, the first signed co-operation agreement between NorCross and SRCS is dated 1982. Following this, the physical rehabilitation program in Somalia was launched following the 1993 telethon fundraising.  The bilateral relationship between SRCS and NorCross has always been very close, with different operational modalities at different times – based on the prevailing situation. In addition to the support on health interventions, NorCross is also one of the main supporters to the core structures of SRCS, which has contributed to reinforce the national society’s position and capability to respond to humanitarian needs and crises in Somalia. NorCross is continually engaged in strengthening SRCS capacities through the national society development activities, with current focus on finance development and resource mobilisation[3].  


The Sustainable Development Goals (SDGs) call for universal access to safe water, dignified sanitation and hygiene (WASH) for all by 2030. For children, this extends beyond the confines of the household to a child’s place of school and play. With children spending several hours a day and over a decade of their growing years in schools, basic access to sustainable WASH in schools is not only crucial for their health and well-being, it is also a fundamental human right. The SDGs exhort countries to build and upgrade education facilities that are child-, disability- and gender-sensitive, and equipped with basic drinking water, single-sex basic sanitation and basic hand washing facilities[4].

Safe and high quality WASH interventions are fundamental to preventing and controlling infection in health facilities, tackling antimicrobial resistance, and ensuring quality of care – a prerequisite for achieving universal health coverage. WASH in health facilities broadly refers to the quantity and quality of, and access to, water, toilets, health care waste management, and hand hygiene facilities; the cleanliness of the environment; and the knowledge and practices of safe hand hygiene.

In addition, when it comes to healthcare facilities, there are several sources of environmental emissions which can negatively contribute to the SDGs. These sources include use of energy, health waste management, water, procurement, and transport. There is also increasing evidence to show how energy-efficient and climate-friendly health services can improve health, while contributing to savings in resources and costs[5].


Rationale for the WASH assessment in health facilities and schools:

Due to the conflict, Somalia has limited resources and capacities to deliver on the needs of their vulnerable population, such as in the case of health and WASH services. The results produced by this assessment will inform the most appropriate ways to improve WASH services and strengthen their capacities, with a special emphasis on environmentally friendly solutions. This assessment further hopes to support local authorities and public institutions, to reprioritise WASH activities and Green health solutions in the areas where the crisis has weakened their capacities for surveillance and action.

Based on the WASH Assessment in the health facilities, a plan will be prepared to address the identified gaps and challenges. The plan will include capacity building and supportive supervision, including but not limited to water quality monitoring, mapping and surveying water points, establishing and supporting water user committees (WUC), and aiding in the operation and maintenance of HFs and community infrastructure.

Target area and target group/beneficiaries:

The assessment will take place in the following health facilities:

Clinic Name

In addition to the above-mentioned clinics, this assessment will include the SRCS physical rehabilitation center in Galkayo.

The assessment will also be conducted in the following schools:

School Name Category District (Clinic)
Godod Primary/Intermediate Balibusle
Gara’ad Primary/Intermediate/secondary Gara’ad (Jariban)
Ba’adweyn  Primary/Intermediate Ba’adweyn
Jeehdin Primary/Intermediate Jeehdin (Galkayo south IDP)
Labilamaane Primary/Intermediate/secondary Labilamaane (Jariban)
Gobsho  Primary/Intermediate Halabokhad
Halabookhad Primary/Intermediate Halabokhad
Cagaaran Primary/Intermediate Cagaaran (Ba’adweyn)
Tawakal Primary/Intermediate Halabokhad (IDP)
Bursalah Primary Bursalah (Galdagob)
Galdogob Primary/Intermediate/secondary Galdagob
Harfo Primary Harfo
Jariiban Primary/Intermediate/secondary Jariban
Darusalam Primary/Intermediate Galdagob

The general objective of the assessment is to provide useful information and evidence that can help to improve the WASH status in the 8 HCFs[6] and 14 selected schools in the Mudug region of Somalia. The HCFs would also benefit from an assessment of their environmental impact and opportunities for “green” technology.

The study shall recommend possible approaches/strategies that could be adopted to enhance efficiency and effectiveness of project interventions as well as engagement of all relevant stakeholders, thereby building on the capacity, clear roles & responsibilities, data & information, financing, monitoring & evaluation, stakeholder engagement, and integrity & transparency.

 Specific objectives

 The purpose of this WASH assessment is to:

  • Identify the existing Water, Sanitation and Hygiene (WASH) conditions in 8 health facilities, and 14 selected schools in Mudug Region, Somalia.
  • Identify the use of green technologies at the health facilities, including technology such as solar panels.
  • Identify gaps in WASH and possible solutions that fill the identified WASH gaps.
  • Analyse the strengths and weaknesses of the WASH committees as the predominant water management model in the intervention areas, and the extent to which they can meet the life cycle costs of different infrastructures (notably solar-powered systems).
  • Identify the gaps, grey areas and overlaps in the WASH institutional environment linking the health facilities to the community level. A special focus on areas which might benefit from environmentally friendly technology or risks linked to WASH and the environment will be highlighted.
  • Develop, in consultation with SRCS, NorCross and other key institutional stakeholders, a (financially) sustainable governance model for health facilities’ water supply systems in line with the legal and institutional framework.
  • Develop a capacity-building strategy (e.g. competency-based trainings, water point information system) for the management of water systems at health facilities, schools and community within the health facilities catchment areas, and identify opportunities for advocacy by SRCS and NorCross to influence the sustainability of WASH interventions.
  • The environmental assessment at the health facilities will identify the main contributors at these facilities to climate change/local environmental degradation and their main vulnerabilities linked to climate change.

Information from the assessment will be utilized as follows:

Direct users: School and health facility management committees, NorCross and SRCS

Indirect users: NorCross International Network, RCRC Movement partners (ICRC, IFRC, PNS), WASH Sector Working Groups, local government and public institutions, INGOs and NGO Consortiums as well as humanitarian learning platforms.


Based on the above objectives, the Consultant will define a detailed methodology and work plan (inception report) to be shared with the project lead for approval. The consultant will undertake both a desk-based review of existing studies and project documents, and conduct fieldwork. The field work will include:


As part of the assessment, the Consultant will be interviewed by NorCross, ICRC and SRCS staff, to agree on expectations and define a road map on how the assessment will be conducted. The interviews will look at project design, data collection, management reporting procedures, and the government policies/guidelines including stakeholders’ involvement in WASH sector. The Consultant will develop data collection tools with the guidance of the project and PMER team, and conduct interviews with the health facilities’ personnel, school officials, relevant government departments’ officials, WASH committees, community leaders/traditional leaders, and other INGOs and UN organizations.

Field visits:

The Consultant will develop a methodology to assess health facilities’ and selected schools’ current WASH status including use of green technology and visit to assess all existing water points in the 8 health facilities and 14 selected schools in Mudug Region.

Stakeholders’ workshop:

The Consultant shall facilitate a learning workshop to the NorCross, ICRC and SRCS team to generate consensus on a sustainable governance model for water points, present the capacity-building strategy, suggest effective green technology approaches among others and gather feedback on the findings and recommendations.


The NorCross programme team will have the following responsibilities:

  • To review TOR and make recommendations
  • To ensure that evaluation process meets the standards of quality and apply the procedures outlined in the SOPs for Quality Assurance and Ethical Standards in NorCross
  • To review inception report, draft and final reports to ensure they meet NorCross’ quality assurance and ethical standards
  • To provide technical advice and support to the evaluation process
  • To provide funding for the evaluation activity
  • To provide final approval of the report

The SRCS (project and M&E team) will have the following responsibilities:

  • To lead the recruitment and survey process
  • To coordinate the assessment implementation process through the SRCS PMER unit
  • To review assessment products including tools and reports
  • To organize the logistics for the assessment team
  • To avail data collectors within agreed criteria
  • To avail of all necessary documents for desk review
  • To mobilize all the relevant stakeholders and local government staff for KII and FGDs
  • To be the link between the community and the consultant
  • To be the custodian of all data generated from the assessment
  • To organize dissemination forums as necessary

The Evaluation Team will have the following roles:

  • Conduct the evaluation by fulfilling the contractual arrangements in line with the TOR and Ethical Guidelines
  • Adhere to NorCross’ Evaluation SOP
  • Demonstrate personal and professional integrity during the whole process of the evaluation
  • Respect the right of institutions and individuals to provide information in confidence and ensure that sensitive data cannot be traced to its source
  • The evaluation process must be sensitive to beliefs, manners, and customs of the social and cultural environment in which they will work. Especially, the team must be sensitive to and address issues of protection, discrimination and gender inequality


The following are study outputs:

  • Submission of inception report and work plan within one week after commencement – the report should include a comprehensive literature review of WASH assessments in the region, methodology of the assessment, main report outlines, planned questions (questionnaires) and stakeholders to engage
  • A literature review of health-focused environmental assessments in the region
  • A draft health facility and schools WASH Assessment report for review by NorCross and the SRCS team
  • A final report with recommendations, including an annex on environmental risks and opportunities in the health facilities
  • A presentation of the study key findings and recommendations for stakeholders
  • A brief list of key issues/questions that may require further analysis/investigation or that merit continued future tracking

This assessment will be for a period of 45 days


The assessment will be carried out by a Consultant/Expert with the following profile:

  • Advanced University degree in Public Health Engineering or related discipline
  • Proven previous experience in humanitarian contexts in similar roles, excellent assessment, analytical and written skills
  • A high level of organizational and coordination skills and willing to travel to and stay in various parts of Somalia
  • At least 5 years of field experience in developing countries
  • Proven ability to organize and manage surveys/assessments in various cultural settings
  • Excellent report writing, communication and presentation skills
  • Understanding of regional context is desirable
  • Fluency in English. Working proficiency of Somali is an asset

Interested applicants are invited to submit:

  1. Lead consultant and assistant CVs
  2. Narrative proposal including work plan with timeline
  3. Detailed and break downed Financial Proposal
  4. All applications should be sent to procure.srcs@gmail.com

The application Deadline is 24th October 2021. At 11:59 PM (Mid night)

[1]SOMALIA COUNTRY BRIEF.docx (sharepoint.com)

[2]SOMALIA COUNTRY BRIEF.docx (sharepoint.com)

[3]Partnership Memo Somali Red Crescent Society 09012017.docx (sharepoint.com)

[4]Scoping Study of WASH in Schools (WinS) Programming in Eastern and Southern Africa

[5] Greening health systems, Expert Meeting Report, August 2013 World Health Organisation

[6] The 8 healthcare facilities include 7 SRCS clinics and 1 physical rehabilitation center in Mudug region



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