TOR- Consultant to conduct baseline assessment for Strengthening Infection Prevention and Control for Improved and Resilient Health Systems in Sierra Leone

Application deadline closed.

Job Description

 

Terms of Reference for Strengthening Infection Prevention and Control for Improved and Resilient Health Systems in Sierra Leone Baseline Survey

International Rescue Committee 

 

Duty Station: Freetown and Bo

 

Job Title: Consultant to conduct baseline assessment for Strengthening Infection Prevention and Control for Improved and Resilient Health Systems in Sierra Leone
Location: Sierra Leone  Employee type: Consultancy
Employee Category: Consultancy Reports to: Senior Health Coordinator
Project Title Strengthening Infection Prevention and Control for Improved and Resilient Health Systems in Sierra Leone
Objectives To conduct baseline assessment in 21 health facilities in Sierra Leone.
Commencement July 1, 2022 Completion August 1, 2022 Expected duration 20 working days
Location Freetown and Bo

 

INTRODUCTION

Infection Prevention and Control (IPC) is essential in maintaining quality health service provision including safeguarding patients and health care workers. The World Health Organization (WHO) has estimated that, at any given time, more than 1.4 million patients are affected by health care associated infections (HAIs), one of the leading causes of mortality and morbidity among hospitalized patients, globally. Achieving high quality IPC standards can be challenging in the fragile and conflict-affected areas where the IRC works. This is due to factors such as limited staffing and inadequate capacity in IPC procedures; lack of leadership and commitment to sustaining standards; poor hygiene practices; weak infrastructure; as well as improper water, sanitation, and waste management systems. Globally, there isn’t enough investment in IPC strengthening in fragile and humanitarian settings, and therefore, it is often prioritized only during outbreaks.

 

The COVID-19 pandemic has halted much of the steady progress that the international community had made in improving health outcomes for people living in fragile and humanitarian contexts. However, it has also put a spotlight on the fragility of health systems globally and forced pain-points that predated the pandemic, to become glaringly evident. Some of these challenges include low staff retention; lack of training on the correct use of personal protective equipment (PPE); supply chain and logistical issues; and inconsistent oversight and management. In addition, with the devastating and far-reaching effects of the pandemic, there was increased risk of more deaths due to the ripple effects of the pandemic, such as the disruption of routine health services as result of these challenges, than to COVID-19 itself. In the face of these challenges and more, stronger health systems and improved services have never been more crucial. 

 

Globally, the IRC has undertaken an ambition to improve IPC across all the health facilities it supports. IRC’s vision is that each health system can provide safe and high-quality care, while building capacity to withstand future shocks. The IRC has conducted baseline assessments across four regions in 1,106 health facilities, documenting challenges in the uptake of IPC improvements. The results showed that the highest performing areas included hygiene, PPE, and water supply, while the lowest performing areas were sanitation, health care waste management, triage, screening, and isolation. The IRC has a long-standing history of providing health care in Sierra Leone and is planning to build on that to not only offer immediate IPC support, but to guide longer term solutions for IPC resiliency in supported districts. The IRC has been providing humanitarian assistance in Sierra Leone since 1998. Sierra Leone has been affected by protracted crises and its health care system has been faced with critical gaps in policies and support structures. The country also has high rates of communicable disease outbreaks. Notably, in 2014 – 2016, the IRC supported the country to respond to the Ebola outbreak and also led multiple cholera outbreak responses. While there were significant IPC and WASH investments made during these outbreaks, longer term support for system leadership and management structures is still lacking, yet, critical to ensure the overall sustainability of IPC and WASH programs.

 

PROJECT DESCRIPTION

The project aims to improve IPC status in targeted health facilities while strengthening local and national governance structures to support maintenance of IPC improvements. This will be achieved through the implementation of a composite set of a continuum of interventions that sums up to improving the quality of infrastructure and practice of IPC and WASH interventions at selected PHUs. IPC in this context includes supportive policy; WASH and Health Care Waste Management infrastructure that meets agreed national standards; improved IPC and quality of care knowledge and practice for health workers; as well as improved awareness of, and knowledge on, IPC at household level. 

 

The IRC plans to use a two-pronged capacity building approach to facility and community-based IPC as well as supporting existing health accountability structures in monitoring and managing IPC activities at supported facilities, as follows:

 

Improve IPC and WASH status in targeted health facilities

The IRC will enhance the support it is currently providing to a total of 21 health facilities (20 PHUs and 1 hospital) in Bo by allocating dedicated resources to strengthen IPC, including basic IPC and WASH infrastructure and technical assistance. The IRC will tailor the support needed by each of the facilities based on findings from the baseline and ongoing assessments. Throughout implementation, the IRC will conduct additional assessments (at least quarterly) to allow for tracking of overall progress as well as identify areas that need corrective actions.

 

Strengthen local and national governance structures to sustain IPC improvements

The IRC will work with various levels of the existing structures (i.e., national, district, facility, and community level teams) to strengthen the overall management and sustainability of IPC and WASH interventions. The IPC and WASH team will support district and primary health unit teams to conduct participatory organizational capacity assessments (OCA) to better understand leadership, coordination, and overall management mechanisms particularly as they relate to IPC and WASH. Based on priorities from the assessments, the IRC will support the development of organizational development (OD) plans to support implementation of IPC and WASH interventions. The IRC will also use community scorecards to engage communities and service providers to assess health service quality with a specific focus on IPC and WASH. The IRC will also conduct IPC and WASH trainings for health care workers based on needs identified through assessments and during mentorship. The IRC will work closely with key stakeholders to strengthen accountability structures where they exist and support their establishment where they do not exist. 

 

OBJECTIVE AND SCOPE OF THE CONSULTANCY

The main objective of this consultancy is to conduct a baseline assessment of the indicators (available upon contracting) which will provide a basis against which ongoing progress will be measured. The assessment will include collection, collation, analysis of quantitative and qualitative data, report writing and presentation.  review

 

METHODOLOGY

Sample size: The target area for the baseline assessment will be 21 health facilities (20 PHUs and 1 hospital) in Bo District where IRC will implement the IPC and WASH project. 

 

Methods: The assessment will involve a mixed methods approach. Both quantitative and qualitative methods will be used to generate the needed data. A structured questionnaire (in form of checklists) will be administered in the targeted health facilities to assess their basic IPC and WASH status – including for health facilities and the capacity of health providers to deliver high quality services that integrate IPC and WASH. Quantitative data will be collected using tablets. In-depth interviews (IDIs) for district and health facility providers as well as focus group discussions (FGDs) for community stakeholders will also be done to collect qualitative data on perceptions, facilitators, and barriers to sustainable IPC improvements. At least one IDI and one FGD per facility will be conducted. In addition, a desk review of the current status of IPC and WASH in the country will be done. Special emphasis will be given to the current situation of IPC and WASH in Bo District.

 

Tools: All assessment tools shall be designed and provided by IRC. The consultation shall receive orientation on the tools before commencing data collection.

 

Analysis and reporting: upon completion of data collection, data will be exported to MS Excel and cleaned before proceeding with analysis using appropriate software. Report writing will be done using MS Word. 

 

Ethical considerations: Participation in IDIs and FGDs will be voluntary. All respondents will be requested for signed consent before participating in the assessment, and they will be informed of their right to withdraw from the exercise at any time. The team will not collect any personal identifiers. However, for ease of analysis and reporting, data collection forms will be coded with facility IDs. 

 

KEY TASKS

The consultant will be expected to work with limited supervision to complete the following tasks on behalf of the IRC. The assignment will be carried out in no more than 20 working days spread over a period ranging from June 20 to July 29, 2022.

 

# Task/Milestone Deliverables/Outputs # of days
1 Attend inception meeting with IRC to ensure common understanding of expectations Approved inception report. The report should contain the following, among others:

  • Situational analysis
  • Understanding of assignment
  • Full methodology
  • Workplan from inception to completion of assignment
  • References
5
2 Conduct desk review on the current state of IPC in Sierra Leone, with focus on Bo District
3 Review data collection tools (that will be provided by IRC) and write up assessment methodology 

(Following IRC guidance, including safeguarding, and the outlined Program Monitoring & Evaluation Framework)

4 Develop full workplan for the assignment 
5 Present workplan to IRC for review 
6 Submit full inception report to IRC for review and approval
7 Train data collectors on data collection approach and tools, including use and management of the tablet  Data collectors trained on assessment tools and methodology 2
8 Conduct IPC and WASH assessment at the target health care facilities Full data set available and shared with IRC   5
9 Conduct data cleaning and analysis (following the analysis plan in inception report) and interpret results and write report* Draft report 1 shared with IRC for review 4
10 Incorporate all comments and inputs from IRC into draft report*  Draft report 2 shared for additional review 1
11 Incorporate additional comments and inputs and share a revised assessment report* Draft report 3 shared with IRC
12 Prepare PowerPoint Presentation and share findings with wider IRC team (during a meeting that will be organized by IRC) Share key findings using a PowerPoint Presentation  1
13 Incorporate feedback from dissemination meeting to finalize assessment report* Final assessment report 2
14 Submit consultancy report Final consultancy report

* The report shall have no more than 10 pages, excluding annexes and references. The structure of the report will be discussed during inception. 

 

WORKING RELATIONSHIPS

The consultant will work closely with the MEL Coordinator and the Senior Health Coordinator.

 

LEVEL OF EFFORT/DELIVERABLES AND TIMING 

The consultant will be paid in four tranches based on delivery of key outputs below:

  • Tranche 1: Submission of approved inception report                          30%
  • Tranche 2: Submission of draft assessment report 1 shared with IRC for review          20%
  • Tranche 3: Submission of final assessment report and final PowerPoint Presentation   20%
  • Tranche 4: Submission of final consultancy report                             30%

 

ASSIGNMENT DOCUMENTS

IRC shall provide supporting documents related to the IPC project:

  • Logical framework and project proposal. 
  • List of indicators.
  • Any other relevant documents.

The consultant shall the duty to search for all other relevant documents that will be used for desk review. 

 

APPLICATION AND SELECTION CRITERIA

Applications are sought from qualified individuals and/or teams. Both international and Sierra Leone nationals residing in Sierra Leone are eligible to apply.

  • Education: Advanced university degree in the fields of public health with specialization in epidemiology, and extensive experience in IPC and WASH in health facility settings, or PhD in health policy/healthcare management or related areas. 
  • Expertise in development of adapting global standards and guidelines for developing countries, national strategies, health policy documents, national policies, and guidelines, especially related to IPC and healthcare waste management.  
  • Work Experience: Minimum 10 years of practical research experience especially in planning and conducting/leading similar assessments; strategic planning and capacity building (mandatory) for health facilities/providers; experience of working with ministries, districts and community stakeholders would be an advantage.
  • Relevant technical expertise and consultancy experience with international organizations in the field of the field of public health and health system strengthening.
  • Competencies: Strong analytical and conceptual thinking, including statistical analysis of both qualitative and quantitative data. Excellent report writing skills. Excellent communication and presentation skills and the ability to work under pressure and commitment to work within a tight timeframe.

 

Applications are required by 9:00am Monday 20th Jun 2022 (Sierra Leone Time). Email enquiries and applications to SL-Administration@rescue.org. Only selected submissions will be considered for interview during the week of 27th June 2022.

 

PROPOSAL BID EVALUATION PROCESS AND METHODS

Individual consultants will be evaluated based on a cumulative analysis methodology. The award of the contract shall be made to the consultant whose offer will win, based on:

  • Responsiveness and compliance with requirements.
  • Having the highest score out of a weighted set of technical and financial criteria (technical criteria – 80% and financial criteria – 20%)

 

Criteria  Weight Max. Point
TECHNICAL QUALIFICATION (max. 80 points) 80% 80
Overall Response (20 points)
Understanding of tasks, objectives and completeness and coherence of response 10
Overall match between the TOR requirements and proposal 10
Proposed Methodology and Approach (20 points)
Quality of proposed approach/methodology 10
Quality (and practicability) of proposed work plan 10
Technical Capacity (40 points)
Advanced university degree in the fields of Public Health, and/or has master’s in Epidemiology, specialization in infection control and WASH, healthcare waste management or PhD in health policy/healthcare management, or any related fields. 8
Minimum 10 years of practical research or evaluation experience: in the field of planning and implementation of the health sector assessments; strategic planning and capacity building; recent experience (within the past 5 years) in the development projects with IPC and WASH and medical waste management in countries with transition economies and experience working with national ministries of health, district, and community leaders. 9
Strong knowledge of maternal and child health, health system strengthening, health policy design, and reform. Familiarity with a rights-based approach, gender and disability mainstreaming and institutional strengthening concepts. 8
Strong statistical analysis and conceptual thinking. Excellent report writing skills. Excellent communication and presentation skills with stakeholders and the ability to work under pressure and commitment to work within a tight timeframe  15
Competitiveness of financial proposal (max. 20 points) (daily rate, lump sum, per deliverable, transportation, etc.) ** 20% 20
TOTAL SCORE (max. 100 points)

** Only candidates who score 65/80 points in the technical criteria will be considered for financial evaluation.

 

SUBMISSION OF BIDS

Your application should include the following:

  • A full technical proposal with the proposed workplan and methodology/approach to managing the entire assignment. The proposal must be costed (in the local currency) at each stage as outlined in the key tasks. 
  • A resume highlighting the relevant work that the Consultant has undertaken and supported by recommendation letters.
  • At least two (2) sample reports written by the Consultant while executing similar assignments. 
  • Financial Proposal: The financial proposal should provide cost estimates for services rendered including daily consultancy fees, training costs, accommodation; transport cost; stationeries, and supplies needed for training and administrative costs related to the participants during the exercise.

 

WORK ARRANGEMENTS

The consultant is expected to:

  • Provide their own laptop computer and other administrative supplies.
  • Be available to work from their own office. NOTE: due to the COVID-19 pandemic, IRC will not provide / allocate a desk within any of the IRC offices.
  • Cater for their own transportation and meals.
  • Be available to travel to the field sites where data will be collected.
  • Provide for their own translator and/or editor as appropriate.
  • Recruit data collectors to conduct collection and data entry. Where necessary, IRC staff will be available to assist with the logistics.