Somalia: TERMS OF REFERENCE FOR ASSESSING PATIENTS’ PERSPECTIVES ON THE QUALITY OF TUBERCULOSIS TREATMENT SERVICES

TERMS OF REFERENCE FOR ASSESSING PATIENTS’ PERSPECTIVES ON THE QUALITY OF TUBERCULOSIS TREATMENT SERVICES IN SOMALILAND, PUNTLAND AND SOUTH CENTRAL SOMALIA

Background information:

Tuberculosis remains a serious public health problem in Somalia. The current all forms of TB incidence for Somalia is estimated at 274/100,000, and TB mortality is estimated at 65/100,000. Since 2009, there has been a sustained annual increase of all forms of TB cases notified to reach the highest number of 14,231 cases in 2016. According to WHO’s Global TB Report 2016, Somalia is detecting only about 47% of the estimated incident cases of all forms of TB. This leaves a huge number of active TB cases in the community undetected and untreated hence enabling further transmissions. Majority of TB patients in Somalia seek care at public TB Centre, raising questions about how best to ensure delivery of quality TB services, prevent transmission and maintain treatment regimens in County.

Assessing quality of TB services from the patient’s perspective is of paramount importance for making the service more responsive to patients. In addition, involving TB patients in service delivery improvement process contributes to empowerment of TB patients and their communities as understood in the Patient Charter for TB Control and Care.

Patient’s perspective is an important element of improving care to better meet their needs, increase equity and improve access to quality services for diagnosis and treatment. TB Patients are therefore considered to be one of the expert groups to assess the quality of TB Services.

A number of management tools are available for measuring the quality of TB Care from the patients’ perspective, combining both the performance and importance of TB care dimensions. Eight quality dimensions for TB care and treatment have been tested quantitatively and validated through statistical analysis. The measurements of the quality of care is based on these eight TB specific dimensions (QUOTE TB tool).

In spite of measurement tools being available, little has been done and documented about the quality of tuberculosis treatment service from the patient’s perspective in Somalia. Therefore, measuring the self-reported quality of care by TB patients using the QUOTE TB tool is the focus of this study. The survey will seek to generate and document information on patients’ perspectives of quality TB services ( 8 quality dimensions) using validated tools and provide practical suggestions/ solutions for the improvement of the quality of World Vision and National TB Programs response to patients in humanitarian crises in complex high threat environments. The study aims to also provide a deeper, more systematic and objective analysis of the extent to which World Vision and NTPs are succeeding or failing to reach affected populations with high quality TB services in a complex high threat environment. This, in turn, should enable World Vison, NTPs and other key partners to innovate and introduce alternative approaches and mitigation measures that will improve the quality of partners’ action in regards to TB care services in such challenging contexts.

The Service & Scope of the contract:

Overall objective: To assess and document information on patients’ perspectives on quality of TB services and provide practical suggestions / recommendations for improving the quality of World Vision and National TB programs work in Somalia

Specific Objectives:

The survey / evaluation has three specific objectives:

1. To determine the patients’ perspective on the quality of TB treatment services focusing on all 8 key quality dimensions.

2. To document what is working well in provision of quality TB treatment services to patients (patients’ perspective) in a complex high threat environments, using both desk and field based studies.

3. To identify the internal and external enabling factors and challenges to World Vison’s and implementing partners performance in responding to patients needs of quality TB services.

Methodology:

Study area: The quality of care study will be done in sampled TBMUs in Puntland, Somaliland and South Central Somalia.

Study Population: TB patients (both drug sensitive and drug resistant TB forms) currently on TB treatment in sampled TBMUs.

Study design: Cross sectional study design

Study duration: Approximately 35 days. Actual dates to be determined during inception meeting in July, 2017.

Process:

The successful consultant in close collaboration with World vision and MoH will carry out quality of TB care services.

The successful proposal will be reviewed by the technical research team including WHO before commencement of the data collection exercise. A constant communication with World Vision will be ensured. Upon completion of data collection, the consultant will perform data analysis and interpretation. The study findings will be presented to the technical team before a final report is printed and submitted to World Vison for final approval.

OUTPUT

1) At inception, the consultant is expected to submit a detailed inception report and plan on how the survey will be carried out including the data collection tools and a comprehensive methodology.

2) Final report both in soft and 5 hard copies including all data sets used during the survey

Deliverables, reporting and project schedule

1. Participation at the kick‐off meeting at World Vison Premises and the detailed report on the discussions and conclusion of the kick‐off meeting, including the key issues discussed and decisions made (to be delivered two weeks after the kick‐off meeting).

2. The updated project work plan for the entire duration of the contract, including general methodological approach, milestones and timelines in accordance with the objectives of the project and decisions of the kick‐off meeting.

3. The two‐page synopsis of the project outlining the general scope and purpose of the project to the relevant stakeholders for their information about the project (to be delivered two weeks after the kick‐off meeting).

4. The work plan, including study protocol, describing study design, methodological approach, analysis plan, expected outputs and timelines

5. Detailed high quality summary report on the studies performed (to be delivered according to the approved project work plan or 1 moth before expiring of the contract).

6. High quality summary report on the study performed (to be delivered 1 month before the end of this contract).

7. A detailed report that should include study findings, realistic and achievable recommendations and next plan of action. The intended target audience for the reports are: TB programme implementers and policy makers at national &international level as well as World Vision Somalia.

Conditions:

1. Sharing with WHO Somalia

Since WHO has technical mandate for TB, the results need to have the approval or at least an acknowledgement from World Health Organization Somalia. In this regard, World Vision will share the Terms of Reference with WHO Somalia (as this been done?). World Vision will also share the methodology of the study, the tools, results and analysis with WHO Somalia once the consultant provides them.

1. Immediately after completion of the survey, a summary report should be presented for discussion by the main stakeholders – (WV, MoH, WHO).

2. Once this is agreed then the final report will be printed.

Management of the Evaluation / survey

While executing this assignment, the consultant and the parties involved shall be guided by the protocol summarized in the matrix below:

No

Stakeholder

Stake / role

1

Consultant

Undertake the study based on the approved design and methodology and timeline

2

GF/PR technical team

Initiate the TOR and seek approval from WV and WHO

Lead the technical recruitment of consultant

Provide technical and managerial leadership to the consultant throughout the study process

3

WV QA / GF Technical team / Research team / WHO / NTP /WVUK

Technical reviews to the ToR, Inception report, study design & methodology

Participate in the technical evaluation of consultants

Review draft report and recommend approval or non-approval

4

Supply Chain Manager

Advertise and complete bid selection processes

5

WV QA / GF Technical team / Research team / WHO / NTP /WVUK

Review of the study findings

Essential qualifications required for this job

The following minimum qualifications are required for this job:

• Candidate must be a master degree holder with competency in social studies and a broad knowledge on international standards for TB care
• Should have minimum of 3 years’ experience in carrying out public health surveys especially in the perspectives of tuberculosis programme and preferably social science studies
• Candidate with previous experience in conducting similar study in the region will have an added advantage
• Have excellent knowledge of both written and spoken English
• Must be computer literate
• Must be familiar with Somali cultures, norms and customs

LOGISTICS

World Vision will provide logistical support, including visa application, facilitation in arranging meetings with partners and relevant authorities. The consultant will be provided with an air ticket to and from the country of origin to Somalia. World Vision will also cover food and accommodation costs including vehicles required to carry out field assignments.

TIMEFRAME

Activity

Location

Timeframe (days)

Nairobi meeting the GF PR team and health partners

Nairobi

1

Review of tools

Nairobi

3

Recruitment and training of enumerators

Somalia

9

Collection of information

Somalia

10 days / zone

Analysis

Nairobi

4

Preparation of Draft report

Nairobi

3

Assimilation of comments

Nairobi

1

Final Report

Nairobi

4

Total

35

Total number of days is 35

INVITATION TO BID

Interested Consultants and Firms are expected to submit a detailed expression of interest (technical and financial proposal) with the following components;

• Their understanding of TOR
• Proposal document detailing the implementation of the inventory study including a detailed study methodology
• Proposed work schedule
• Proposed Budget in USD
• A profile of the firm including full name(s), physical addresses, telephone numbers.
• Copies of CVs of all the consultants who will undertake the evaluation

Applications from qualified firms/individuals should be submitted by 19^th June 2017 to somo_supplychain@wvi.org

World Vision reserves the right to Award the contract to a bidder of its choice, even if its bid is not the lowest. World Vision shall not in any way be obliged to reveal, or discuss with any bidder, how a proposal was assessed, or to provide any other information relative to the evaluation/selection process or to state the reasons for elimination to any bidder.

NOTE: Evaluation of proposals and selection of the service provider will be performed in accordance with the request for Proposal (RFP), which is based on World Vision’s procurement rules and regulations.

Applications from qualified firms/individuals should be submitted by 26th June 2017 to somo_supplychain@wvi.org