PROJECT TITLE: MdM/AFD Multi-Year Partnership Agreement – Improving access to health services and the rights of vulnerable populations, through the promotion and dissemination of pilot programs and expertise in Risk Reduction, Sexual and Reproductive Health and Rights, and Environmental Health
COUNTRIES: Algeria, Burkina Faso, Ivory Coast, Ethiopia, Madagascar, Democratic Republic of Congo (DRC), Nepal, Philippines Myanmar,
DATE OF WRITING: 03/25/2025
I. CONTEXTE
PROJECT PRESENTATION
Since 2007, MdM has implemented several Program Agreements on themes such as Gender-Based Violence (GBV), Sexual and Reproductive Health (SRH), Harm Reduction (HR) and Unwanted Pregnancies (UNP). MdM is now continuing to strengthen its operations and expertise internationally for access to health services and the rights of particularly vulnerable populations through the Multi-Year Partnership Agreement (CPP), whose first funding phase 2018-2021 has been completed and focused on two main areas: HR (drug use and sex work) and SRHR (cervical cancer). The current CPP covering the period 2022-2025 is structured around 3 priority areas: HR (sex work), SRHR (cervical cancer) and environmental health . The first two axes respond to a logic of consolidating the achievements of the first CPP funding cycle, while the third axis is part of the synergy of the other two (notably through a risk reduction approach) and allows for better consideration of environmental factors influencing human health.
Table 1 – List of CPP2 intervention countries
REMINDER EVALUATION OF CPP 1
The evaluation focused on the following objectives:
– Assess exit and transfer strategies to civil society and local authorities, with the aim of determining the sustainability of interventions, their ownership by operational partners, and thus improving future exit and transfer strategies.
– Establish the relevance between the CPP tool and the strategic management of the MdM thematic cycle.
– Study the internal management of the CPP financial instrument by MdM, by analyzing the way in which the teams, at headquarters and in the field, organized themselves in the management of a complex, multi-country and multi-thematic tool.
Main recommendations
-Rearticulate the notions of universal access to health with more vertical thematic interventions at the operational level.
-Go further in integrating the concepts of health financing and financial resilience of healthcare systems.
-Define more strategically the role and goals given to studies and research in the positioning of MdM.
-Make a clear choice to use the CPP as a structuring strategic program rather than as a flexible tool allowing the financing of various activities.
-Strengthen coherence between multi-themes and multi-countries in order to increase synergies.
-Improve program coordination to maximize funding benefits.
-Ensure better readability of the final objectives sought by MdM and put in place criteria triggering exit strategies in order to accentuate the sustainability of the actions.
-Strengthen the structuring of the partner selection process in order to further strengthen the partnership model.
-Systematize the strengthening of the organizational capacities of partners in order to ensure their financial sustainability.
– Demonstrate a certain flexibility in the intervention model, particularly concerning the transfer of capacities.
Monitoring of recommendations and issues
Following the recommendations of the first CPP, MdM worked to strengthen coordination within the program and clarify its governance . The teams created a Project Committee (COPROJ) in charge of monitoring and coordination as well as a Steering Committee (COPIL), responsible for arbitrating and making the necessary decisions concerning the major strategic, programmatic and budgetary orientations. The operational thematic committees strengthen the inter-project link and thematic coherence. As for the tripartite monitoring committees between MdM, the AFD and the Minister of Foreign Affairs, they promote accountability and are a key space for strategic discussions contributing to making the CPP a structuring strategic program.
The Steering Committee (COPIL) of this evaluation has chosen not to include certain subjects , because they represent major issues for Médecins du Monde (MdM), included in Strategic Plan 2 and already dealt with in specific working groups:
This particularly concerns the integration of the gender approach in the projects supported by this CPP, which varies from one mission to another. Some missions have benefited from the support of a gender referent, training plans, as well as tools for programming and monitoring/evaluation, while others have not carried out a gender assessment. Gender integration remains a key issue for MdM, as highlighted in Strategic Plan 2. The organization adopted a gender policy in 2020 and is now working to make it operational, notably thanks to the arrival of a Gender Referent in 2024, after a vacancy in the position. On this subject, MdM is committed to developing an Action Plan and strengthening its teams in order to achieve its strategic ambitions. Furthermore, this theme is the subject of evaluations within the framework of projects, both in France and internationally. Consequently, the Steering Committee has decided not to include it in this evaluation.
Although MdM has not yet established a formal framework (process, reference framework) for exit and transfer strategies with institutional partners and civil society, some elements are being integrated more systematically at the operational level. Furthermore, new operational situations regularly contribute to enriching recommendations and lessons learned internally. Indeed, each mission/project works on the exit strategy as an integral component of the country’s operational strategy. For example, regarding the cervical cancer (CCU) project in Burkina Faso, several scenarios were defined and costed, then a trade-off was made and the exit strategy was subsequently implemented. This experience has allowed MdM to formalize an operational decision-making tool. Furthermore, MdM has the financial, HR, and logistical tools to manage base/mission closures when necessary. Finally, the working group on partnerships within the framework of MdM’s Strategic Plan will contribute to discussions on exit and transfer strategies with institutional partners.
II. OBJECTIVES OF THE EVALUATION AND TARGET AUDIENCE
OBJECTIVES OF THE EVALUATION
Common thread of this evaluation:
To assess how the CPP has contributed to the development and strengthening of MdM’s expertise on the three priority themes , by promoting the acquisition and dissemination of knowledge internally (head office and field), as well as among field partners. Thus, the evaluation will measure the extent to which the CPP has responded to the leverage effect [1] sought by this financing mechanism.
General objective:
Analyzes the contribution of the CPP in strengthening the expertise of MdM and its partners on the three themes, highlighting the dynamics of capitalizing on knowledge and improving practices.
Measure the leverage effect of the CPP in terms of structuring, innovation and adaptation of interventions to the specific challenges of each theme.
ASSESSMENT PERIMETERS
The evaluation will cover all interventions carried out between January 2022 and September 2025 in the 9 countries concerned. Interviews will have to be conducted with stakeholders of all interventions covered by the CPP. However, the scope of the field evaluation mission will be limited to a minimum of 3 countries (1 per intervention theme, see Table 1 on page 2). The details of the countries chosen must be mentioned by the bidder, the list will be refined with the steering committee team during the scoping phase depending on the access conditions (security and administrative) in the countries.
RECIPIENTS OF THE EVALUATION
This assessment aims to be used by several audiences (English and French speaking):
- Internally: by MdM teams at headquarters and in the areas of intervention concerned by the CPP, or potentially involved in multi-country and cross-cutting programs in the future;
- And external:
- By MdM partners in the various areas of intervention, to strengthen ownership of the results obtained and contribute to the sustainability of good practices;
- By other partners, in particular those who benefit from similar financing tools;
- By the French Development Agency, within a framework of accountability and in order to provide a support for exchange, capitalization and improvement of development aid practices.
III. EVALUATION CRITERIA
MdM and AFD base the evaluation of their projects on the six criteria defined by the OECD Development Assistance Committee (DAC): relevance, coherence, effectiveness, efficiency, impact and sustainability. However, as AFD specifies in its principles relating to the evaluations of projects it co-finances3, “this normative framework can be adapted to take into account the specificities of the projects or portfolios of projects evaluated and reflect the main objective sought (accountability or learning). Beyond the DAC criteria and/or by referring to them, it is a question of identifying the evaluative questions that the evaluation will seek to answer in relation to the objectives that the project initially set itself (…). It is therefore not a question of using all the DAC criteria in each evaluation at the risk of having an evaluation that skims over the project and provides few lessons.”
It is therefore planned that this evaluation will be structured around evaluative questions grouped into 3 topics. The consulting team will be asked, for each of these questions, to analyze them with regard to the most relevant CAD criteria.
MAIN EVALUATION QUESTIONS
1. Partnerships
General Questions
Has the CPP helped to strengthen the capacities and promote the development of expertise among our operational partners? Has the CPP enabled MdM to formalize operational and strategic partnerships that promote its development of expertise? What could be the short- and medium-term perspectives (both operational and conceptual/strategic) on these partnership issues?
- Assess the extent to which the CPP has helped to strengthen the capacities of partners and promote their increased expertise.
- Analyze MdM’s capacity to play the role of an effective and reliable partner through the following axes: quality of collaboration (communication, coordination mechanisms and decision-making mechanisms); transparency and information sharing, resource management (financial, human, material), adaptability (reaction and response to the needs of partners), sustainability. Formulate practical and targeted recommendations to improve the quality of collaboration, the effectiveness of interventions, and the sustainability of partnerships.
- Identify strategic partnerships to strengthen to optimize impact.
- Examine the contribution of partnerships to the dissemination and institutionalization of MdM expertise.
Did the CPP promote exchanges, cross-views and capitalizations between MdM, the AFD, the French public authorities, and research organizations where appropriate, on themes of shared interest, linked to MdM’s area(s) of expertise? (Joint actions to make more audible advocacy internationally; capitalization exercises, action research, production of knowledge for wide dissemination; feeding into the strategies of the MEAE and the AFD on the themes concerned).
Specific questions by theme:
- DSSR / Cervical Cancer
What partnerships should be strengthened to ensure greater impact at the national level (public, private, CSOs, etc.)?
- RdR – Sex Work
Have partnerships with local actors consolidated over time (NIKAT in Ethiopia, for example) or more recent ones (the LGBT network in Madagascar), as well as actors with whom it already collaborates at the regional or international level, such as NSWP or ESWA, enabled the consolidation, harmonization and dissemination of MdM’s expertise on the RdR-TdS axis?
- Environmental health
Explore the interest for MdM in developing new university and scientific partnerships outside its usual scope of health actors, particularly in complementary sectors (environment, urban planning, etc.), in order to strengthen the impact of SE interventions.
2. Increased expertise
A. General Questions
Research and studies (capitalization, operational research, evaluations):
- Evaluate how the research and studies carried out have helped to document the situation and adapt our intervention strategies.
- Analyze the impact of studies and research conducted on intervention strategies and the quality of practices. Have they enabled the desired objectives to be achieved? Have they promoted increased expertise and improved the quality of practices? Examine whether the activities implemented have enabled a gradual increase in expertise adapted to the realities of the intervention areas.
B. Specific questions by theme
- Health-Environment
Has the CPP helped to strengthen the formalization and dissemination of MdM expertise on Environmental Health (internally and externally)? What are the gaps/avenues/opportunities to achieve this more comprehensively?
How have the Health Environment expertises at MdM (housing and occupational health) had an impact on users/beneficiaries and partners?
How did this CPP help structure the expertise and influence of Médecins du Monde on the health issues to which vulnerable populations are exposed in their living or working environment?
Has the integration of the SE into the CPP made it possible, on an operational level, to achieve a critical mass of international projects, to structure expertise, a capacity for action and influence, and thus to create a leverage effect?
- DSSR / Cervical Cancer
Did the second CPP cycle achieve a significant level of deployment on the ground and consolidate the expertise and advocacy of MdM and its partners? Did the CPP formalize expertise through pilot projects? Are they ready to scale up? What would be MdM’s limitations/strengths in moving to national scale up of our operational approach? What factors will facilitate or hinder the scaling up of SRHR pilot projects? What strategic partnerships should be developed?
Did the CPP promote or not the integrated approach to SRHR? Did the CPP effectively support the strengthening of the continuum of care and rights in SRHR, since the prevention of UCC constitutes an entry point to other issues, and vice versa (STIs, comprehensive sexuality education, gender-based violence, etc.)?
- Sex Work
Has the CPP helped strengthen the formalization and dissemination of MdM expertise on Sex Work (internally and externally)? What are the gaps/avenues/opportunities to achieve this more comprehensively? Are the implementation of advocacy activities by MdM and its partners in the countries of intervention effective? Has the CPP helped strengthen MdM’s capacities and therefore support its advocacy at the field and cross-functional levels?
3. Transversality at the thematic and operational level
At the thematic level
- Assess whether the CPP has enabled the development of an inter-thematic approach, particularly between CCU/TDS, Health Environment/DSSR and Health Environment/TDS.
- Analyze synergies between themes through joint advocacy actions, sharing of tools, positioning on common issues and participation in common spaces.
- Examine the extent to which activities from one theme have been integrated into the programming of another theme.
- Evaluate the pooling of human, financial, logistical and technical resources between the different themes.
At the operational level:
- Analyze the impact of inter-project practice exchange workshops on the development of expertise at the operational level.
- To assess whether these exchanges have contributed to improving the quality of practices implemented in the field.
- Identify opportunities to further strengthen these cross-functional dynamics.
IV. PREFERENCES METHODOLOGIQUES
QUANTITATIVE / QUALITATIVE METHODS
It is up to the consulting team to propose a methodological approach presenting the combination of qualitative and/or quantitative methods best suited to meet the objectives, questions, duration and contexts defined in these Terms of Reference. The proposed methodology must be participatory, with strong involvement of MdM headquarters and field teams, as well as the operational and financial partners of the program. It will be described in the technical proposal submitted in response to the call for tenders and then detailed in the framework note presented to the Steering Committee for validation.
DOCUMENTS CLES
The list and number of key documents will be completed after the scoping meeting with the consulting team. At a minimum, below are those to be taken into account:
- CPP Doctrine Note
- Proposal for the Multi-annual Partnership Agreement detailing the content of the program, including the logical framework;
- Interim report and activity programme for tranche 2;
- Updated CPP Governance Scheme;
- Monitoring report of the various country projects targeted by this external evaluation;
- Biannual reports on the progress of the CPP (memos);
- NGO strategy documents: Strategic Plan and Associative Project
- Framework and/or strategic documents (programs and advocacy) on the projects involved in the CPP;
- Thematic strategies for SRHR, RdR and Health-Environment
- Productions produced within the framework of the CPP, including: training tools; reference frameworks; socio-anthropological and epidemiological studies; mathematical modeling and capitalizations:
- PowerPoint presentations and written reports of the operational thematic committees;
- PowerPoint presentations from the Tripartite Steering Committee (AFD, MdM, MEAE)
- “Methodological guide – Support mechanism for initiatives of civil society organizations”, AFD, 2024
- Evaluation report of the previous CPP
KEY PEOPLE / INSTITUTIONS
- Association executives, managers and salaried directors
- Members of the coordination team or Project Committee (COPROJ);
- Relevant desk managers and health representatives,
- Thematic and advocacy referents concerned,
- Managers of relevant geographic and thematic areas
- Members of the field coordination teams
- Institutional and civil society partners
This list will be completed and refined if necessary during the framing phase and according to the request of the evaluation team.
V. CALENDAR
April 2025 – November 2025
Indicative timetable for the execution of the study
Study start date: April 2025
- Meeting 1 – Steering Committee: Discussions on the ToRs and preparation of the call for tenders / end of March 2025.
- Launch of the call for tenders / beginning of April 2025 in two rounds for a first return (note of intent) of offers 3 weeks later – around the end of April 2025 and a second (complete technical and financial offer) 3 weeks later – end of May 2025.
- Meeting 2 – Steering Committee: Choice of a technical and financial offer / last week of April 2025 / beginning of May 2025.
- Contracting with consultants at the beginning of June 2025. (Start of the evaluation with the selected service provider: first half of June 2025).
- Meeting 3 – Steering Committee: production of a framework note for the evaluation based on the offer and the ToR / June 2025. Finalization of the framework note taking into account the comments of the steering committee, sending to the steering committee and remote validation by the latter / end of June 2025.
- Document analysis phase / July 2025.
- Send interim note (one week before the meeting) / end of July 2025
- Meeting 4 – Steering Committee: Discussion on the interim report and formalization of the rest of the evaluation work – first half of August 2025.
- Finalization of the interim note taking into account the comments of the steering committee, sending to the steering committee and remote validation by the latter / before the end of August 2025
- Meeting 5 – Steering Committee: submission of the provisional report / early October 2025, (the report must be sent at least one week before the meeting)
- Validation of the final report: end of October/beginning of November 2025
- Final return date to be specified: end of November 2025/ first week of December 2025 .
Consultants may suggest adjustments to the schedule if necessary .
End of study date: November 2025 / return December 2025
- PRODUCTION AND RETURN EXPECTED
DELIVERABLES
Framework note (method, evaluation tools, planning):
Maximum 10 pages, excluding annexes including evaluation tools. Produced on the basis of the review of key documents and initial interviews, the framework note defines and formalizes the proposed methodology, specifies the evaluation matrix, presents the necessary data collection instruments and proposes a realistic work plan with a detailed and definitive timetable. The framework note will be submitted to the Steering Committee for comment and validation.
Reports
A draft version of the final evaluation report will be produced at the end of the fieldwork phase. It will be submitted to the Steering Committee for comments and discussion. The final evaluation report must take into account the Steering Committee’s comments on the draft report. The main text of the evaluation report, in Word format, should be between 40 and 50 pages (excluding annexes), font size 11 and single-spaced, and should include the following sections:
- Executive summary (maximum 5 pages, translated into French and English)
- Introduction
- List of acronyms
- Background (project description)
- Objectives of the evaluation and criteria selected
- Methodology and limitations
- Main results and analysis
- Conclusions and recommendations (classified according to the evaluation criteria)
- Appendices: Terms of Reference, list of people met and calendar, questionnaires, interview guides, observation grids, etc.
The final report must be available in French and English. Translation costs must be included in the consulting team’s financial proposal.
Restitution workshop
Consultants are asked to include in their technical and financial proposal the organization of a workshop to present the results of the evaluation to stakeholders from MdM and AFD / MEAE. AFD and MdM will be able to provide facilitation and logistical and organizational support. The consultants will offer a PowerPoint presentation and will lead this presentation according to the terms proposed in the technical offer, discussed and validated with the members of the Steering Committee.
BUDGET AVAILABLE
The total budget available for this evaluation amounts to a maximum of €30,000 including tax, all costs included, including unforeseen expenses (maximum 5%), remuneration costs for the evaluation team (fees and per diem ), organization of the results restitution workshop and all other costs related to the implementation of the evaluation. In its budget proposal, the evaluation team will make a detailed budget proposal with a breakdown of costs including tax by expenditure item.
REQUIRED SKILLS
It is required from the consultant team.
- Proven experience in evaluating humanitarian and development projects. Previous experience evaluating a multi-country program would be a plus.
- Proven experience in development cooperation, in NGOs or international solidarity organizations.
- Fluency in French and English.
- Advanced public health skills.
Specific technical skills required:
- Knowledge and understanding of the issues of Risk Reduction, Sexual and Reproductive Health and Rights, and Environmental Health
- Proven experience in organizational strategy.
[1] Leverage effect understood as the result of the thematic cross-functional and operational activities implemented during the 4 years of the project and resulting in a positive result in terms of: evolution of the sphere of influence for the implementation of larger-scale advocacy, obtaining new operational and/or financial partners, new strategic partnerships, etc. The leverage effect sought is to encourage the scaling up of projects.
How to apply
APPLICATION FILE
TERMS AND CONDITIONS FOR SUBMITTING APPLICATIONS
Consultants invited to submit a tender must provide a complete file of 10 to 15 pages maximum including the following elements to the email address: “doi.applications@medecinsdumonde.net” specifying in the subject line “CPP AFD/Multipays Evaluation”:
Technical proposal including:
- Understanding the terms of reference
- The technical approach developed and the detailed methodology,
- The composition of the team, the distribution of responsibilities among its members, the CVs and the availability of the proposed members
- The projected schedule for the mission as well as an estimate of the man/day costs
- References to 2 previous similar works
- A sworn statement attesting to the absence of conflict of interest
Financial proposal including:
- The total budget including tax, including the budget breakdown (fees, living expenses, transport, interpreter, etc.).
Final date for receipt of application files: 04/30/2025 6:00 p.m. Paris time
- INSTRUCTIONS TO BIDDERS
To be eligible to apply, bidders must be able to demonstrate, at MdM’s discretion, that they meet the required legal, technical and financial conditions and that they have the necessary capacity and sufficient resources to carry out the evaluation mission. The following rules are intended to assist the bidder in preparing a complete document that meets MdM’s requirements.
Content of the service offer
The bidder must provide all necessary and sufficient information to enable the proper evaluation of the technical and budgetary proposal. The information provided must be concise and cover all aspects. The bidder must be able to demonstrate how it has the qualifications required to carry out the evaluation mission. The bidder may add any information deemed relevant.
Exclusion criteria
MdM will exclude from the procurement procedure tenderers falling into any of the following cases:
- They are in a state of or are the subject of bankruptcy, liquidation, judicial settlement or preventive composition proceedings, cessation of activity, or are in any similar situation resulting from a procedure of the same nature provided for in national laws or regulations;
- They are subject to a conviction pronounced by a judgment having the force of res judicata (that is to say, against which there is no further possible appeal) for any offense affecting their professional morality;
- They committed serious professional misconduct as demonstrated by any means that MdM can justify;
- They have not fulfilled their obligations relating to the payment of social security contributions or their obligations relating to the payment of their taxes in accordance with the legal provisions concerning them;
- They have been the subject of a judgment having the force of res judicata for fraud, corruption, participation in a criminal organization or any other illegal activity;
- Following the award procedure for another contract, they were declared in serious breach of contract due to failure to comply with their contractual obligations.
Bidders must be able to certify by any appropriate means that they are not in one of the situations listed above.
Ineligibility clauses
Contracts shall not be awarded to tenderers who, during the procurement procedure:
- Are in a situation of conflict of interest or have an equivalent specific link with other bidders or other parties to the project; any attempt by a bidder to obtain confidential information, to enter into illicit agreements with its competitors or to influence the Evaluation Steering Committee or MdM during the procedure of examination, clarification, evaluation and comparison of offers will result in the rejection of its offer;
- Were guilty of false declarations in providing the information required by MdM for their participation in the market or did not provide this information.
Causes of rejection
MdM and bidders observe the highest ethical standards during procurement and contract performance.
MdM rejects any proposal submitted by bidders and terminates their contract if it is established that they have engaged in corrupt, fraudulent, collusive, or coercive practices. The administrative or financial penalties applied must be proportionate to the importance of the contract and the seriousness of the misconduct.
MdM must ensure that candidates and bidders do not exploit child labor and that they respect social rights and basic working conditions. They themselves must undertake not to purchase goods from suppliers who exploit child labor or violate social rights and/or basic working conditions.
