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Tenders are invited for Evaluation of New Partnerships in the Programme Close the Gap: Sufficient, Competent and Motivated Nurses and Midwives in Tanzania and Zimbabwe. Closing Date: 3 Apr 2026 Introduction This is the Terms of Reference (ToR) for the Evaluation of the programme CLOSE THE GAP: SUFFICIENT, COMPETENT AND MOTIVATED NURSES AND MIDWIVES (GLO-0759 RAF-23/0074) and its local partners Tanzania National Nurses Association (TANNA) in Tanzania and Zimbabwe Nurses Association (ZINA) in Zimbabwe. The current programme agreement and plan started on 31.3.2024. The current programme period ends on 31.12.2028. This ToR sets out the expectations for this Evaluation process and deliverables. II. Background a) About NNO The Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund, NSF) is a national professional nurses organisation and labour union representing about 130,000 registered nurses, midwives and nursing students in Norway. NNO was founded in 1912 and focuses on professional, social, and representational policies, concerning areas such as public health, ethical nursing standards, as well as collective bargaining aimed at improving, e.g., working hours, working conditions and pay. NNO is politically neutral and has some 3000 elected union representatives. NNO has been involved in international development work since the 1980s, with programmes/projects supporting the development of strong nurses organisations in Africa. This work has been, and currently is, supported and partly financed by the Norwegian Agency for Development Cooperation (Norad1). b) About TANNA The Tanzania National Nurses Association (TANNA) has approximately 10 000 members, with 57 regional branches across Tanzania. The Nurses Association was founded in 1971. In 2005 the constitution was reviewed and the association changed to its current name to Tanzania National Nurses Association (TANNA), including both registered and enrolled nurses to join the organisation. TANNA is a professional organisation and was established to unite and empower nurses and midwives, promote professional development, uphold ethical standards, advocate for members rights and welfare, and contribute to the delivery of high-quality healthcare services. TANNA is currently in process of transferring status from association to union, a change that will enable TANNA to negotiate and undertake collective bargaining for the nurses/midwives it represents. The TANNA leadership is elected during the Annual General Meeting. Elections are conducted every three years. The association also has a board of trustees appointed for a tenure of three years. Moreover, the association is governed by a Nurses National Council of leaders from the 57 branches, and the day-to-day affairs are overseen by an elected National Executive Committee of 10 individuals. c) About ZINA Founded in 1980, Zimbabwe Nurses Association (ZINA) is both a nurses union and a nurses organisation. ZINA currently has a membership of around 9,400 nurses. ZINA draws its membership from public and private health facilities in the country. It is a supportive body for all nursing matters related to education, service, leadership development, standards, and quality care. The organization is managed by a standing committee of six members plus ten provincial chairmen. It operates in compliance with Zimbabwes National Nurses Act and Nursing Council Code of Ethics. ZINA is the only voice of nurses in Zimbabwe covering the public sector, private sectors and mission institutions. Moreover, ZINA is registered as a trade union, with the legal mandate to negotiate with government on working conditions. As a mother body, ZINA has subgroups under its umbrella. These include the Association of Midwives, Anaesthetists, Occupational Health Nurses, and Mental Health Nurses. ZINA is also affiliated with regional, international, and local associations. These include the Southern African Network for Nurses and Midwives (SANNAM) and the Eastern, Central and Southern African College of Nursing (ESACON), and the International Council of Nurses (ICN). ZINAs vision is to advocate for empowered nursing, evolving nursing profession and accessible healthcare in Zimbabwe. c) NNOs partnership model As described in NNOs Strategy for International Development Cooperation (2023-2029), civil society is an important driving force in societal development in all countries. Strong and independent organisations can help promote democratisation, realise human rights, and reduce poverty. NNO believes that strong nurses and midwives organisations are important contributors in holding governments accountable for having sufficient, competent, and motivated health personnel in a country. This is at the core of NNOs partnership model. NNOs partnership model puts increasing emphasis on technical and professional cooperation with decreasing financial support to administration. This is reflected in collaborative project activities like joint seminars and knowledge exchange in areas like advocacy/lobbying; membership recruitment/administration; strategic communication; and organisational development of democratic member-based organisations. The division of labour, roles, and responsibilities between NNO and its partners differs slightly depending on the activity. In most cases, the partner is the implementer while NNO has a supporting and/or advisory function. For example, in terms of organisational development, the local partner is responsible for planning, executing, and evaluating local trainings. NNO may be a discussion partner in terms of e.g., the content of the training, and may also contribute with an expert. In other areas, NNO might have more responsibility for organising and delivering capacity building activities, especially when there are specific expertise or experiences within the NNO structure that is to be shared with the partner. When NNO has a more active role in the activity, emphasis is on making sure that the capacity of the partner is strengthened during the process. In terms of other technical support, NNO often challenges the partner when it comes to for example setting realistic targets, how to assess learning outcomes, how to ensure learning is applied, the documentation of results, etc. This is followed by support, e.g., on how to develop and use simple monitoring and evaluation tools, and how to analyse and apply findings. d) Brief programme background The 5-year programme, Closing the Gap: Sufficient, Competent and Motivated Nurses and Midwives (GLO-0759 RAF-23/0074) is co-funded by the Norwegian Agency for Development cooperation (Norad) and NNO and has four local partners: National Organisation of Nurses and Midwives of Malawi (NONM), Rwanda Nurses and Midwives Union (RNMU), Tanzania National Nurses Association (TANNA), and Zimbabwe Nurses Association (ZINA). The two latter are subject to this Evaluation. In brief, the core of the programme is summarized as follows: Nurses and midwives are the backbone of the health system. Yet they are overworked, undervalued, and underpaid. Many also lack the skills, equipment, and support to do their job effectively, and safely. These are contributors to the fact that Africa is lacking millions of health personnel. The planned effect on society of this programme is that universally accessible, equitable, and affordable quality health services are ensured in Malawi, Rwanda, Tanzania and Zimbabwe. The goal of the programme is to contribute to having sufficient, competent, and motivated nurses and midwives capable of addressing the populations current and emerging health needs. Civil society, represented by strong and independent organisations, is an important driving force in development. Hence NNO provides professional, technical, and financial support to TANNA and ZINA for them to be: 1) a democratic, accountable, inclusive and sustainable organisations for nurses and midwives in Tanzania and Zimbabwe respectively; and 2) effective watchdogs and advocates. By realising these outcomes, TANNA and ZINA will contribute to better status, pay and working conditions for nurses and midwives; a more competent, qualified, and capable healthcare workforce; greater leadership opportunities for women; and better healthcare and public-sector policy, legislation, and reforms, amongst others. This will again contribute towards the realization of countries current and emerging health needs. III. Objective and purpose of the Evaluation The evaluation is set out as a requirement in GLO-0759 RAF-23/0074, Specific Conditions §9.1: Reviews focusing on progress to date shall be carried out for each of the country projects: TANNA and ZINA by end of 2026; [...]. The Evaluation aims to: a) assess and describe the level of progress in TANNA and ZINA, and the partnership achieving its planned outputs, outcomes and overall objective in the programme period 2024-2026, including cross-cutting issues as gender, inclusion, and equality, as set out in the results framework. b) assess and describe, if relevant, if there are any other achievements/results/impacts that are not covered by the projects result framework, but that the project has contributed directly to, especially since 2024 and to date. c) assess TANNA and ZINA and the partnerships alignment with and potential contribution to national plans and targets/goals, and map potential opportunities at the national level. d) reflect on potential wider societal impact that the development of TANNA and ZINA may have in the two countries, and how the organisations could position themselves to maximize potential impact. e) give examples of positive change that TANNA and ZINA have contributed to, for 1) nurses and midwives, 2) the nursing- and the midwifery professions, 3) patients, and 4) society at large f) assess how the prog Tender Link : https://reliefweb.int/job/4201009/evaluation-new-partnerships-programme-close-gap-sufficient-competent-and-motivated-nurses-and-midwives-tanzania-and-zimbabwe
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