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TERMS OF REFERENCE FOR CONSULTANT OR ORGANISATION TO DEVELOP JOB AIDS FOR HEALTH CARE WORKERS AND IEC MATERIAL FOR CLIENTS ON INTEGRATED SRH/HIV SERVICES

 

Background

Globally significant progress has been made in reducing both the spread of HIV and the number of maternal deaths. Despite these impressive gains, HIV and maternal mortality are still two primary causes of death in women of reproductive age worldwide. Nine countries in this region have the highest HIV prevalence in the world (Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland and Zimbabwe) with HIV resulting in the single sharpest reversal in human development in the region. The region also continues to experience high rates of preventable maternal mortality, teenage pregnancy and gender based violence. 

The interactions between SRH and HIV are now widely recognized.  Majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Sexually transmitted infections can increase the risk of HIV acquisition and transmission. An effective response to the HIV/AIDS pandemic cannot be achieved without addressing the social and structural drivers such as poverty, migration, gender inequality and gender-based violence that underpin and fuel the pandemic. These drivers facilitate new infections, deter individuals from undergoing HIV testing, inhibit retention in care and treatment, and contribute to internal and external stigma.

In recent years, there has been strong international consensus on the benefits of providing integrated SRH, HIV, TB and SGBV services, particularly as a strategy to increase the effectiveness of the HIV response.

Integration of SRH, HIV, TB and GBV     

The importance of linking sexual and reproductive health (SRH) and HIV response has been increasingly gaining momentum. SRH services can provide a platform for reaching individuals, especially women and children with HIV prevention, care and treatment interventions. At the same time, HIV services can provide an effective entry point for key SRH services such as HIV counselling and testing, TB screening, STI screening and treatment, family planning, cervical cancer screening, gender based violence care and antenatal care including PMTCT. Emerging evidence demonstrates that integrating comprehensive SRH and HIV services provides an opportunity to increase access to and uptake of quality maternal and reproductive health services and improves programme efficiencies and effectiveness.

Evidence from a number of countries suggest that through rapid scale up of specific interventions that integrate sexual and reproductive health (SRH), TB and HIV services  it is possible to:

·         Promote health, wellbeing and rights of women and children

·         Reduce maternal morbidity and mortality

·         Prevent new HIV infections

·         Eliminate AIDS related deaths

The South African National Department of Health commissioned a joint review of the HIV, TB and PMTCT programme in 2013 to assess the performance of HIV, TB and PMTCT programme and identify issues critical to the delivery and impact of HIV, TB and PMTCT. The findings of this review indicate among others that there is successful, functional integration of HIV, TB and PMTCT services, particularly at primary care level.

In addition, a rapid appraisal of integration of SRH, HIV and TB services conducted in 2015 in three districts (EThekwini, Gert Sibande and Dr. Kenneth Kaunda) found that there is incomplete integration for family planning services as HIV counselling is only provided on request by the clients and thereafter patients are referred to the necessary services as required. There is no TB screening for patients attending family planning services. Hence, there is a need to assess integration of SRH, HIV, TB and SGBV services in the UNFPA supported districts in the Eastern Cape to identify gaps and develop interventions to improve and scale up integration of services.  

UNFPA in collaboration with Department of Health has conducted a rapid assessment on SRH and HIV integration of five (5) facilities in uThukela district in Kwa-Zulu Natal and five (5) facilities in OR Tambo and Alfred Nzo district in the Eastern Cape. The results of the assessment will be utilized to strengthen SRH and HIV integration in the ten health facilities as well as finalize a minimum package of care for SRH and HIV integration.  To further strengthen the operationalization of SRH and HIV integration in the health facilities, UNFPA is seeking for a service provider to use information from the rapid assessment of SRH/HIV integration conducted in 10 health facilities to develop job aids to guide health care workers and inform clients (community) on SRH/HIV integration.  

Purpose of the consultancy

The assignment is aimed at developing user friendly job aids for health care workers preferably algorithms and Information Education (IEC) material for clients that come for services at health centers. 

Objectives

  1. To conduct a desktop review of all the materials, Job aids and IEC materials that have been developed on SRH/HIV integration within SADC.
  2.  To develop draft job aids for health care workers, preferably algorithms to further guide the provision of integrated SRH/HIV services in primary health facilities.
  3. Posttest the draft job aids to ensure that they are easy to use and they follow the current PHC model as well as the sequence for service provision.  
  4. Consult the district team and health facility teams to validate the job aids
  5. Finalize the job aids
  6. Develop  IEC materials in English and local language( Xhosa and Zulu) to inform clients( community) on SRH/HIV integration and the benefits of integrated services

 

  1. Scope of work
  1. Develop and present an inception report detailing your interpretation of the terms of reference, methodology to be used and undertake a desk review of the existing SRH/HIV assessment, SRH/ HIV integration algorithms, existing policies and guidelines and other documents.
  2. Conduct focus group with health care workers to develop the draft job aids that are informed by health care workers (preferably algorithms) and IEC materials for clients in the local language.
  3. Develop draft job aids and IEC materials
  4. Pre-test the job aids with relevant stakeholders including the district health teams and facility staff to ensure that they are logical and are easy to follow. 
  5.  Pre- test the  IEC material with relevant community stakeholders
  6. Posttest both the job aids and the IEC material  
  7. Review the developed materials based on feedback post testing.
  8.  Finalize the tools including design and layout for both materials
  9. Submit an acceptable print ready electronic version of the materials 

 

  1. Expected deliverables

All final deliverables must be accepted by UNFPA

  1. Final designed print ready IEC material for the ( clients) community on integration in English, Xhosa and Zulu
  2. Final designed print ready Job aids consisting of algorithms for health care workers to guide SRH/HIV integration,  from acute care, chronic care and maternal care service delivery points aligned to the  ideal clinic model.

 

  1. Assignment duration and management arrangement       

Twenty four days (24) spread over - October- November 2017.

·         Inception report and desk review : 5 days

·         Development of tools : 10 days

·         Pre-testing: 5 days

·         Review and  finalization: 4 days

 

In response to the TOR, the service provider will submit an inception report which will include a review of the existing assessment results, the package of care, policies, strategies & guidelines, interpretation of the ToRs, the proposed methodology, tools and timelines for undertaking this assessment.

 

 

  1.  Service provider eligibility

The service provider should;

  1. Be an organization or an individual with the relevant experience designing and developing materials and clinical care algorithms for  health care settings
  2. Must have demonstrable previous experience in assessment of SRHR and or HIV programmes
  3. Have a postgraduate degree in Medicine, Public health or Epidemiology.
  4. Have at least 5 years of experience in management of sexual and reproductive health and or HIV programmes including SRH/HIV integration
  5. Be familiar with government health policies, systems and structures.
  6. Have excellent interpersonal and communication skills

 

  1. Reporting

The successful candidate will administratively be under the overall supervision of the UNFPA but will report directly to, and work collaboratively with the two districts, Provincial Counterparts and the UNFPA National Program Officer (SRH) to deliver the assignment.

  1. Proposal evaluation criteria

Criteria

Weight

Technical approach, methodology and level of understanding of the objectives and scope of the assignment

30

Profile of the institution/company/individual and relevance to the project; professional experience of the staff that will be deployed to the project

 

40

Demonstrated understanding of SRHR and HIV prevention issues affecting young people as well as SBCC within  the south African contexts

30

 

  1. Cost of technical assistance and payment modalities

A work plan with detailed and itemised budget should form part of the proposal. Proposals submitted without a detailed budget will not be considered.

The maximum budget allocated for the consultancy in ZAR 120,000. However, the most competitive proposal which will be satisfying the requirements of UNFPA will be selected and awarded the contract. The proposal evaluation and the contract award will be undertaken according to UNFPA regulations.

Payment for services rendered shall be effected in tranches agreed upon between UNFPA and the successful service provider. These will be affected to pre-determined milestones and systematic submissions of acceptable deliverables within timelines agreed on between UNFPA and the service provider.

  1. Proposal requirements

Interested services providers are invited to submit proposals to provide the above mentioned services. The proposal should focus on addressing the consultant’s ability to provide the services outlined in the Scope of Work. Interested applicants are requested to submit the following to zaf.admin@unfpa.org by the 10 October 2017:

  1. Cover letter
  2. Detailed CV(s) indicating qualifications and relevant experience
  3. A proposal indicating a description of the proposed approach to the scope of work, work plan with timelines and detailed budget (inclusive of VAT)
  4. Sample(s) of recent written work of a similar assignment.