Request For Expression of Interest to Evaluate Micro-Enterprise Initiatives Implemented within the ComBaCaL Project
(Individual Consultants or Consulting Firms)
- SolidarMed and ComBaCaL Project Background
SolidarMed is a leading non-profit organisation working to improve the health care of 2.5 million people in Lesotho, Mozambique, Tanzania, Zambia and Zimbabwe. Working with national partners to strengthen health systems and community capacities, we are committed to scientific evidence and policy dialogue as foundations and objectives of our work. In 2020, a consortium led by SolidarMed won a competitive call by the Swiss Development Cooperation with a project to improve the health and well-being of people suffering from non-communicable diseases (NCDs) in Lesotho: ComBaCaL (Community-Based Chronic Disease Care Lesotho). The consortium’s other members are the Ministry of Health Lesotho, the National University Lesotho (NUL), the University of Basel (Switzerland), the World Diabetes Foundation and community representatives of Butha-Buthe plus Mokhotlong. The project is for 5 years, from January 2021 to December 2025. ComBaCaL aims to establish and validate a large-scale community-based integrated NCD care model built upon the Village Health Worker (VHWs) program, where VHWs working for the project generate self-sustainable income through Micro-Enterprise (ME) initiatives. Projects other components are –
- Decentralized Diabetes/Hypertension care through VHWs with a possible thematic expansion.
- The e-Health clinical decision support tool (CHT platform app loaded on a tablet) guides VHWs in screening, diagnosing, and monitoring patients at the village and district levels.
- Cluster-randomized trial within Pilot & Main Cohort to generate policy-relevant evidence.
- Health System Strengthening to improve the facility-based health outcomes of patients with diabetes and hypertension.
2. Aim of Micro-Enterprise Initiatives
Typically, VHWs reside in rural areas and offer various health services to communities. They receive only a monthly stipend of M 800.00 from the government for their health-related tasks. However, inadequate compensation from the government is also one of the reasons why VHWs do not effectively perform health-related tasks in the allocated community. The government’s investment in building VHWs’ capacities usually does not lead to a desirable impact as VHWs, due to demotivation, either discontinue or do not routinely perform health-related tasks and venture into other economic activities to earn a living. The ME initiatives under ComBaCaL allow VHWs to increase their income and remain motivated to perform health tasks effectively. It has been envisioned that VHWs working on the project can earn an income in addition to the small monthly stipend the government provides for their health-related tasks, leading to greater economic independence.
3. Current Micro-Enterprise initiatives status
VHWs received training on the Start and Improve Your Business (SIYB) programme, a tool that provides the necessary business skills to minimally educated laypeople. SIYB Trained ComBaCaL VHW develops a business plan to set up a micro-business with a start-up loan of M 15,000.00, which is interest-free and is repayable in 3 years. The initiatives provide a VHW with an opportunity to generate additional income while continuing to perform health-related tasks. About 50 VHWs accessed the loan and started small businesses; a few have begun loan repayment. The micro-businesses grown and run by the VHWs are of diverse types, which include the following: M-pesa agent, dairy cow, veterinary medicine sales, grocery shop, potato production, plant seeds + nutrients sales, poultry, old-clothes sales, fast food, maize sales and maize milling.
4. Consultancy Work scope & Objectives
The selected consultant shall include in their proposal a comprehensive methodology with appropriate references to support the method, which has a representative sample of ComBaCaL VHWs and stakeholders (internal & external) to identify the unmet needs and opportunities. As appropriate, a quantitative and qualitative review of initiatives. As an outcome, we foresee the consultant looking into aspects to measure the success/potential of the micro-businesses under the domains of business performance, customer satisfaction, operational efficiency (cost-efficiency metrics) and community impact. The objectives are the following –
- To assess whether the ME initiatives have effectively improved the economic independence and quality of life of the ComBaCaL VHWs and whether they are scalable beyond the project intervention districts.
- To examine whether ComBaCaL VHWs have gathered enough skill and acumen to generate personal revenue after accessing an ME loan.
- Examine the economic (cost/benefit) analysis of ME initiatives.
- Assess the ME initiatives’ impact on the community and VHW (VHWs job motivation and villagers’ perceptions of a VHW running a business and offering health-related tasks).
- Sustainability and VHWs’ financial independence (without the continuous injection of our start-up funds, the survival probability).
- Key informant interviews with the micro-enterprise coordinator/assistant, district health officials, Ministry of Health’s VHW Program, Ministry of Trade representative, BEDCO district representatives, and other stakeholders to explore alignment with government policies (e.g. VHW policy) and existing remuneration schemes that would reflect sustainability.
- Propose solutions to the identified gaps in the micro-enterprise initiatives, including a value proposition, risk and mitigation, management structure modifications, and a scaling-up strategy.
5. Schedule and shortlisting criteria
The award for consultancy will be done by 25th April, the period to conclude the data and information collection will be from 1st May to 30th June 2025, and the first draft report submission is on 6th July. The final report submission deadline is 31st July, and strict adherence to the timeframe is required. The consultant must attend ComBaCaL’s extended management team (EMT) meeting to get approval for the proposed methodology. Also, during the consultancy period until the report is finalised and accepted, attend the EMT meeting as requested upon request. The shortlisting criteria are:
| Criteria | Description | Weightage |
| 1 | General Experience Individual/firm/company | 10% |
| 2 | Specific experience in the evaluation of medium or small-scale business programs | 40% |
| 3 | Key experts | 30% |
| 4 | Evaluation cost | 20% |
Consultants may enhance their qualifications by collaborating with other firms in a joint venture or a sub-consultancy.
6. Submission Guidelines
Eligible Consultant(s)/firm should submit a consultancy proposal letter in electronic format, along with their CV(s) and team composition, detailing how they will approach the task, their background, and a detailed budget, including tax, per diems, travel, and other incidental costs. Interested consultant(s) should email their applications to [email protected] before the close of business on April 04, 2025, with the Subject line: Micro-Enterprise Initiatives Evaluation Consultancy. NB: Only short-listed consultant(s) will be contacted.