1. Context and presentation of the project
1.1 Intervention context
The Central African Republic (CAR) remains facing a complex and fragile situation in 2025, marked by significant challenges in several areas. On the security front, the country continues to face persistent instability, with the active presence of armed groups, regular clashes, massive population displacements and considerable humanitarian needs. The unstable security situation complicates the implementation of development projects and the country’s governance, while reinforcing social and health vulnerabilities.
Governance remains fragile, heavily dependent on international support, particularly from technical and financial partners, including the United States, the main contributor to humanitarian aid. The reduction or withdrawal of this aid, announced in early 2025 with the withdrawal of USAID, would risk seriously compromising vital programs, particularly in health, water, nutrition and the protection of vulnerable populations.
On the economic front, the CAR is struggling to regain lasting stability. Poverty remains extremely high, affecting approximately 71% of the population, and could worsen with the decline in international aid. Reliance on international funding is essential to support reform, development, and economic stabilization efforts.
In terms of health, the CAR faces major challenges related to endemic diseases. Malaria remains the leading cause of morbidity and mortality, particularly among children under 5 and pregnant women, with an incidence of 310 cases per 1,000 inhabitants, among the highest in the world. The fight against this disease is reinforced by chemoprevention strategies, the effectiveness of which remains limited. HIV prevalence, although declining since 2013, remains a concern at 2.4% in 2024 in the general population, with higher transmission in urban and
conflict-affected areas as well as among key and vulnerable populations. Tuberculosis (TB), with a high incidence of 540 cases per 100,000 inhabitants, also represents a major challenge, especially in areas with high insecurity and difficult access. The fight against these diseases benefits from international support, mainly from the Global Fund, but the persistence of these pathologies endangers the health of millions of people.
1.2 Project intervention logic
General objective:
Contribute to the reduction of morbidity and mortality linked to HIV, TB and malaria among target populations through improving access to integrated health care in districts, prioritizing key populations and under-covered areas.
Specific objectives:
● HIV : Reduce new infections by 50%, reduce the mother-to-child transmission rate to less than 5%, and halve AIDS-related deaths by 2027, while strengthening the fight against human rights, gender, and access to care.
● TB : Increase TB treatment coverage to 90%, improve the treatment success rate to at least 90%, and strengthen integration and governance of the fight against tuberculosis by 2028.
● Malaria : Reduce malaria mortality and incidence by at least 80% by 2028, strengthen community participation, improve surveillance and drug availability, and ensure the protection of 80% of the population at risk through effective interventions.
2. Rationale, objectives of the capitalization study
2.1 Rationale for the capitalization mission
The community engagement department in the Central African Republic is integrated within the Ministry of Health and Population, notably through the Directorate of Primary Health Care, in collaboration with civil society. In 2023, the new Community Engagement Policy for Health and Well-being by 2030 (PECS) and its strategic plan were adopted to strengthen community health. The Global Fund GC7 grant (2024-2026), with the French Red Cross (CRF) as the principal beneficiary since 2018, aims to consolidate these interventions, notably through the deployment of multi-skilled community health workers and through support to Civil Society Organizations (CSOs) by the CRF in the implementation of activities such as community-led monitoring (CLM). These actions aim to develop a multi-sectoral, inclusive and efficient community health system, promoting gender, equity and human rights, while positively influencing public health policies. The Civil Society Organizations Coordination Platform (PCOS) plays a key role in the management, training and monitoring of CSOs engaged in the fight against major pathologies and pandemics. Among its members, three CSOs manage observatories focused on 3 main areas: 1/ access to treatment and availability of services monitored by Seni Na Maingo (SNM), 2/ gender-based violence (GBV) monitored by ANJFAS, and 3/ discrimination of patients’ rights monitored by RCED. A recent reorganization aims to evolve these observatories from an alert-based system to a more inclusive and efficient community monitoring mechanism, involving more agents from the communities benefiting from the services. At the operational level, the CLM has taken the form of a situational analysis of community needs and barriers to accessing services, the selection of relevant indicators, data collection and quality auditing, and analysis. It also includes the production of information, holding meetings to define advocacy priorities, and the implementation of targeted actions and joint problem-solving to promote behavior change.
Community-Led Monitoring (CLM) is an innovative and participatory approach aimed at strengthening the voice of communities in the monitoring and evaluation of health services, particularly in the fight against HIV, tuberculosis, malaria, as well as in the promotion of health-related rights and the fight against GBV. In CAR, CLM has helped to mobilize and further involve communities in the collection, analysis, and use of data to influence policies and improve the quality of services. Capitalizing on this experience will help identify good practices, challenges, lessons learned, and propose recommendations for the development and sustainability of the mechanism.
2.2 General and specific objectives of the capitalization mission
Strategic axis (mission)
Capitalize on the practices of setting up CLM observatories by CSOs in CAR, with a view to replicability and advocacy.
General objective
Consolidate and document the achievements of the implementation of the CLM within the framework of FM grants in CAR, in order to promote the sustainability, extension and effectiveness of this mechanism over time.
More specifically, this involves:
Analyzing the experiences of setting up the CLM system
Characterizing the deployment conditions, key stages (preparation, collection, analysis, action, advocacy) and tools used.
Examining the contextual adaptations in relation to the three areas of intervention: access to care, human rights, GBV.
Documenting the roles, interactions and governance dynamics
Mapping the relationships between CSOs, the Central African Red Cross (CRCA), observatories, PCOS, health authorities and communities.
Identify coordination mechanisms, power relations, levels of community participation and cross-cutting issues (gender, equity, human rights).
Analyze the effects of the CLM on services, human rights and the fight against GBV.
Analyze changes in clinical practices, behaviors, commitment of local authorities and community mobilization at each stage of restitution, advocacy and results.
Identify good practices, challenges and levers for improvement
. Target alert management, data quality, case monitoring, effectiveness of responses and accountability of actors.
Formulate recommendations for the sustainability of the system.
Recommendations in line with national strategies, institutional capacity, financial continuity and community dynamics.
Propose elements of replicability for other contexts
Propose avenues for improvement
Provide practical kits/tools based on key factors and conditions of adaptation and advocacy messages to promote the expertise developed.
2.3 Main targets of the capitalization exercise
This capitalization will be aimed at three types of target:
– the CRF project team, the entire CRF delegation in the CAR and more broadly at the International Operations Directorate (DOI)
– CSOs, the CRCA as well as partners and stakeholders of the current grant such as the MSP teams
– technical and financial partners including the FM, donors
3. Scope of the capitalization study
3.1 Scope of the capitalization exercise
This study, planned for the months of October to December 2025, will cover the Global Fund’s NFM3 and GC7 grants, i.e. the period 2021-2025 for the entire country. Travel to the 3 health districts of the Bangui health region (RS7) and three health districts (Berberati, Carnot and Gamboula) of the Berberati region (RS2) is expected.
This capitalization exercise will focus on three main areas of the CLM, including:
– The observatory of the availability of services and equitable access to health care
– Human rights aimed at raising awareness of the new HIV law, the patient charter, access to legal aid, as well as non-stigmatization/discrimination of patients
– Gender-Based Violence
3.2 Questions of the capitalization exercise
To achieve the objectives of this exercise, the questions were pre-identified and formulated according to each area. However, the list of questions below is not exhaustive and may be reworked by the consulting team in the framework note
Implementation of the CLM:
– What were the key steps and conditions necessary for the implementation of the CLM in the FOSA and within the communities?
– What tools, approaches or methodologies were used to launch the observatories?
– What difficulties were encountered during the collection, analysis and use of data by the observatories?
– Did the implementation of the CLM help to strengthen the capacities of the FOSA (staff, management, local governance)?
– What was the perception of the COGES/COSA/beneficiaries regarding the deployment of the CLM in health structures?
Actors and governance dynamics:
– What role did CSOs, platforms (PCOS), observatories and community agents play in the functioning of the CLM?
– How did interactions between community actors, health personnel and local structures (COSA, COGES) evolve?
– How were coordination, feedback and problem-solving mechanisms implemented?
– To what extent were service beneficiaries involved in the monitoring and accountability process?
Effects, improvements and challenges
Axis 1 – Observatory of service availability and equitable access
What are the main data collected by the observatory on the availability of health services (staff, medicines, equipment, opening hours, shortages, etc.)?
What trends have been identified regarding access to care in different geographical areas or for different population groups (particularly key and vulnerable populations)?
What concrete actions have been undertaken following the alerts or results issued by the
observatories to improve access to care?
How has the CLM contributed to improving access to health services for vulnerable populations?
Has the observatory helped to adapt or strengthen local or national public health policies?
Axis 2 – Human rights and the fight against stigma/discrimination
What are the main provisions of the new HIV law that have been communicated to communities?
How has the patient charter been disseminated, popularized and integrated into health facilities?
What actions have been taken to inform and raise awareness among patients and healthcare providers about their health rights?
What major barriers have been identified in accessing legal aid for people living with HIV or victims of rights violations?
What strategies have helped reduce stigma and discrimination against people living with HIV?
Axis 3 – Gender-Based Violence (GBV)
What forms of GBV have been identified as the most frequent in the
intervention areas?
What actions have been implemented to raise awareness among communities about GBV prevention?
What were the communities’ reactions and feedback to these awareness-raising activities?
What difficulties persist in the detection, referral or care of GBV victims?
What good practices or recommendations have emerged to strengthen the fight against GBV in a community setting?
Sustainability and replicability:
– What are the conditions necessary for the sustainability of the CLM after the end of the grant (institutional anchoring, local capacities, financing, etc.)?
– What steps have been taken to integrate the CLM into public policies or national community health strategies?
– What adaptations would be necessary to transpose the CLM model to other geographical contexts or countries of intervention of the CRF?
– What tools or resources (kits, guides, protocols) can facilitate the replication of the CLM system?
– What key messages or results can be promoted in the context of advocacy with donors, the Ministry of Health or other partners?
4. Capitalization methodology
4.1 Start-up phase, field data collection:
This section proposes the methodological guidelines and expectations envisaged. These methodological guidelines are not exhaustive and it is expected that the technical offer will further guide these guidelines and advise the CRF with specific methodological proposals. The final methodological choices must be detailed in the mission framing note by the consultants based on their understanding of the context, identified needs and issues, as well as taking into account the topics raised during the framing workshop.
In order to meet the objectives and questions, it is suggested to carry out the following work:
Carrying out a documentary review: collecting documents, reports, tools and other productions related to the CLM to establish an initial inventory. Carrying out qualitative data
collection : individual interviews and focus groups with key stakeholders (CSOs, FOSAs, community workers, health officials, partners, beneficiaries). The organizations pre-identified for collection are: CRF, UNAIDS, CRCA, RCED, PCOS, ANJFAS and SNM. Regarding the FOSAs, it is expected to have a representative sample, to identify two FOSAs per selected districts with at least 4 focus groups per FOSA. All capitalization work must follow a participatory and collective intelligence approach to mobilize stakeholders
The various analyses produced will ultimately have to be the subject of a cross-analysis of the data and results from the investigations carried out . These analyses will make it possible to respond to the various objectives and questions raised. The capitalization work will have to identify the contextual elements, the points of action, the blockages and the main orientations to be addressed to the CRF and its partners.
Point of vigilance: the various methodological suggestions presented above are not exhaustive and are complementary (are not to be taken independently). It is strongly recommended that consultants propose a methodology adapted to their understanding of the said terms of reference.
4.2 Analysis and writing phase of capitalization deliverables
The following steps are planned as part of the analysis and preparation of the final report:
– Data analysis following the collection phase (analysis of primary and secondary, quantitative and qualitative data)
– Drafting of the report – provisional version for validation by the CRF
– Presentation of the provisional results during a restitution workshop for amendments and consideration of feedback and proposed amendments
– Production of the final report integrating the information from the restitution workshop
– Final presentation of the final results, conclusions and recommendations.
At the end, a database of the different recommendations will be validated and the various lessons learned will be identified with an analysis matrix of successes, failures, potential and obstacles.
A provisional report and capitalization sheets by axis will be produced and shared for validation.
4.3 Dissemination of capitalization results
Dissemination channels envisaged:
– Sharing by email
– Internal workshop for the presentation of results
– External workshop for CSOs, partners
Following the dissemination, an action plan to follow up on the various recommendations will be developed with partners to enable the practical implementation of these recommendations.
5. Deliverables and Rendering Schedule
Start-up phase:
Drafting of a framing report including the detailed methodology for collecting quantitative and qualitative data; data collection tools, facilitation methods, and the detailed work plan to achieve the targeted capitalization work.
Analysis matrix of the capitalization axes including, for each question identified in the capitalization exercise, the response elements from the collection of field and secondary data;
Field data collection phase
Field mission for the collection of primary data and consultation of stakeholders using different collection and facilitation methods adapted to the target audience. Consultants may request the CRF team in CAR for data collection;
A summary database of focus groups;
A provisional database of recommendations;
A hot restitution workshop at the end of the data collection mission to present the initial results and enrich the analysis with stakeholders
Analysis and writing phase of capitalization deliverables
Analysis matrix including for each capitalization axis identified in the methodology, the response elements from the collection of secondary data (documentary review) and primary data (field data) – to be adapted to the capitalization objectives;
Documentary review including the analysis of secondary data,
Triangulation of the different data collected (primary and secondary);
Provisional version of the capitalization deliverables: a complete provisional capitalization report meeting the set objectives and short and visual deliverables for distribution to the various technical and financial partners, donors, CSOs (formats to be discussed during the framing meeting)
Workshops for co-construction of recommendations with stakeholders;
Restitution phase
Field restitution workshop for presentation of the provisional capitalization deliverables to be amended
Presentations and restitutions of the capitalization deliverables in final version (after revision and integration of feedback from the provisional restitution workshop) to partners (CSOs, FM, etc.)
Video presentation and restitution of the final capitalization deliverables at the coordination and headquarters levels
6. Timeline
The total duration of the consultancy is estimated at approximately 30 days.
7. Terms of submission of the offer
7.1 Candidate profile
For this consultancy, it is desirable to have a pair of consultants (international and national)
● Have a higher education degree at least BAC+5 level in social sciences, or in
public health but with expertise in community health. Expertise in
humanitarian governance or CSO management is an asset
● Proven experience in capitalization work
● Knowledge of the Global Fund
● Mastery of issues related to HIV, community approach, human rights and gender-based violence
● Have a good knowledge of national, regional and local policies, mechanisms and strategies related to community health policies and strategies and specifically on the CLM mechanism
● Graphic skills and visual representations would be an asset
● Present evidence of similar achievements
● Be available for the duration of the mission.
7.2 Content of offers
This file includes in particular:
– CVs
– A technical offer presenting the understanding of these terms of reference, the proposed approach including a detailed methodology in relation to the criteria mentioned;
– A financial offer including all costs related to the performance of the service
– A reference table of the main similar achievements (maximum 10)
Note : the candidates will be selected on the basis of technical criteria (experience,
relevance, proposed methodology, etc.) (60%) and financial criteria (efficiency) (40%)
How to apply
7.3 Sending of offers
Technical and financial offers and associated documents must be sent by email before
09/26/2025 at 12 p.m. CET to:
Laure Gigout, FM Grant Manager
Email: laure.gigout@croix-rouge.fr