Expression of interest for Assessment of Community Health Extension Workers (CHEWs) Program Implementation Fidelity and Bottleneck Analysis

Background

FHI 360, an international non-profit organization dedicated to improving health and human development/EpiC Project invites qualified and eligible firms to submit Expression of Interest for Assessment of Community Health Extension Workers (CHEWs) Program Implementation Fidelity and Bottleneck Analysis.

The Community Health Extension Workers (CHEWs) program is a strategic investment designed to strengthen community-based health service delivery and bridge the gap between local communities and the formal health system. To date, the program has rolled out to over 38 districts, with more than 5,000 CHEWs trained and deployed. As the program transitions from medium-scale to full national expansion, there is a critical need to assess implementation fidelity, identify successes and bottlenecks, and generate evidence-based recommendations to ensure an effective scale-up.

Purpose and Objectives

The purpose of this consultancy is to conduct a rapid, comprehensive assessment of the CHEWs program implementation across selected districts. The assessment will evaluate adherence to program design, identify factors enabling or constraining effective implementation, and provide actionable recommendations for national expansion.

Specific Objectives:

• Assess Implementation Fidelity: Evaluate the extent to which recruitment, training, deployment, supervision, and service delivery protocols align with the original program design.

• Identify Successes: Document effective practices, enabling factors, and positive outcomes to be replicated during scale-up.

• Identify Bottlenecks and Barriers: Systematically identify constraints affecting the institutionalization of the CHEWs cadre, including structural, systemic, operational, and human resource barriers.

• Analyze Functionality and Integration: Assess how effectively CHEWs are integrated into the health system, focusing on primary health care (PHC) linkages, referral pathways, and data systems.

• Evaluate Service Delivery: Examine the coverage, quality, and equity of the integrated health service package delivered by CHEWs.

• Generate Scale-Up Recommendations: Provide prioritized evidence-based recommendations to inform a sustainable national scale-up strategy.

Scope of Work

The firm will conduct a rapid mixed-methods assessment across a purposively selected sample of districts, ensuring representation of diverse contexts (urban/rural, high/low performing, and various regional implementation timelines).

Key Assessment Areas:

1. Implementation Progress: Reviewing recruitment processes, training quality, and adherence to the implementation timeline.

2. CHEW Functionality: Evaluating workload distribution, productivity, and the adequacy of available supplies and equipment.

3. Supervision and Performance: Assessing the effectiveness of mentoring, on-the-job support, and financial or non-financial incentive structures.

4. System Integration: Analyzing the clarity of roles, coordination between stakeholders, and financial sustainability/budget allocations.

5. Stakeholder Acceptance: Documenting community trust and identifying any role confusion or resistance among existing health facility staff.

6. Deliverables and Timeline

   • The total duration of this consultancy is 5 weeks.

   • Week 1: Inception Report (detailed methodology, work plan, and data collection tools).

   • Weeks 2–4: Field assessment and stakeholder validation sessions.

   • Week 5: Final Assessment Report (maximum 40 pages) and a PowerPoint presentation of findings and recommendations.

Management and Reporting

The firm will receive technical oversight from the Ministry of Health Team. The findings will directly inform corrective actions and the national scale-up strategy to build a sustainable, high-performing community health system.

Eligibility

1. The firm must be legally registered and operating in Uganda with at least two years of active service as an institution/consulting firm.

2. Should have evidence of ever undertaking documentation of health programs in Uganda.

3. Having conducted any Community Health Workers’ assessment is added advantage.

4. The team leader should have experience in health systems strengthening, and health workforce development.

Submission Details

Deadline: April 6, 2026 at 5:00pm Uganda time
Address: Uganda.procurement@fhi360.org
Subject Line: Expression of Interest – Assessment of CHEWs Program Implementation