Country: Somalia
Closing date: 25 Sep 2016
TERMS OF REFERENCE FOR AN ASSESSMENT OF PRACTICAL APPROACH TO LUNG HEALTH (PAL) ON TUBERCULOSIS PROGRAM IN SOMALILAND, PUNTLAND AND SOUTH CENTRAL SOMALIA
Position: PRACTICAL APPROACH TO LUNG HEALTH (PAL) CONSULTANT
Organization: WV Somalia; TB Control Program
1.INTRODUCTION
Tuberculosis control programme in Somaliland, Puntland and South & Central Somalia is being done through the various national tuberculosis programmes and based in the ministries of health. The national tuberculosis programme works in close collaboration with World Health Organization, Global Fund (GF), United Nations Agencies (UN), donors and Non-Governmental Organizations (NGOs) in addressing menace of tuberculosis as well as other humanitarian needs. Case detection of TB in Somalia is low at 48% and it means over a half of the new cases of TB are missed and therefore not being treated.
Practical Approach to Lung Health (PAL) has been designed to contribute to improving the case detection component of the Global DOTS Expansion Plan (GDEP) for TB control. PAL addresses the quality of respiratory care in primary health care (PHC) settings, and the efficiency of respiratory service delivery within health systems. According to WHO, up to 33% of patients over the age of 5 years attending PHC settings seek health care for respiratory symptoms. A big proportion of these have TB and therefore TB cases should ideally be detected among patients with respiratory symptoms within such settings. In actual practice in Somalia, antibiotics are usually prescribed for more than two-thirds of patients with respiratory symptoms
PAL is more of an instructional initiative and targets training the clinical staff in the health facilities to know how to deal with cough cases, suspect TB cases and refer them for definitive diagnosis of TB and treatment at NTP facilities mainly primary health facilities such as District Hospital, Health Centres, and referral health centres, MCH/OPDs and primary health unit.
In Somalia context PAL and Private Public Mix (PPM) work together synergistically to maximize the resources and skills that each health provider can offer and improve case detection and treatment outcome of by the NTP programme.
2.BACKGROUND TO GLOBAL FUND TB PROGRAM IN SOMALIA
Global Fund TB programme (GFATM started in August 2004 with the first five year. Since then, the Global Fund has signed three agreements with World Vision International as a Principal Recipient to fund the approved project proposals of Round 3, Round 7 and Round 10. Although there is an understanding that Global Fund TB programme only provides an additional support to ongoing tuberculosis programme, in reality the fund is the main support for TB programme in Somalia given that the governments have scarce resources to support TB programme.
Funding from Round 3, significantly boosted the TB care in this country of complex emergency. Due to the absence of the central government, TB care has been provided through a collaborative arrangement amongst international and national partners and zonal health authorities. Funding from Round 7(2008 to 2012) addressed gaps identified in Round 3 such as the need to expand DOTS centres; Practical Approach to Lung Health and Public Private Mix as well as Multi-Drug Resistant TB. Round 10 which is currently in the final phase is pursuing high quality DOTS and enhancing its expansion; addressing TB/HIV collaboration; MDR-TB and other challenges. It is also contributing to health system strengthening by engaging all care providers; empowering people with TB and communities to fully participate in the programme and increase the case detection and also prevention of TB. The question that is often being asked is to what extent is PAL contributing to finding of the missed TB case in Somalia and what needs to be done to strengthen the PAL program for better performance?
A baseline review of PAL activities done in 2014 and it revealed the various aspects of PAL/PPM being implemented by health actors. Some health facilities were reported to be referring presumptive TB cases for screening at TBMUs. The assessment on the other hand identified gaps at various levels (process; strategy as well as implementation levels). Gaps attributed to weak health system and gaps due to inadequate stakeholders’ involvement were also identified.
A 2nd PAL assessment is proposed for 2016 to determine the status quo as of now, whether there has been further improvement on these or not. The result of this assessment will be important in planning for the Programme and generate evidence to inform next NFM concept note proposal to GFATM in 2017.
3.OBJECTIVE OF THE ASSESSMENT
- To understand the PAL implementation strategy and practices at Health facilities related to TB patient case finding and referral mechanisms in Somalia.
Summary of the assigned responsibilities
The consultant will perform his/her duties under the supervision of the WV Somalia.
4.TERMS OF REFERENCE
The terms of reference for this consultancy will be as follows: -
1) To conduct assessment of current implementation of PAL/PPM activities in NTP programme
2) To establish what went well and what did not go well in PAL initiative
3) To conduct an assessment of how PAL and PPM are collaborating in practice
4) To come up with ways of strengthening PAL and how to improve the collaboration with PPM for the benefit of NTP
5.OUTPUT
At inception, the consultant is expected to submit a detailed plan for how the assessment will be carried out including the data collection tools and methodology.
Expected deliverables from the consultancy includes: -
The consultant shall submit a detailed report that should include his findings, realistic and achievable recommendations and next plan of action. They should be five bind hard copies and one electronic copy at the end of the exercise.
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. World Vision will also share the methodology of the study, the tools, results and analysis with WHO Somalia once the consultant provides them.
- Immediately after completion of the survey, a summary report should be presented for discussion by the main stakeholders – (WV and WHO).
3. Once this is agreed then the final report be printed.**
Essential qualifications required for this job**
The following minimum qualifications are required for this job:
- Candidate must be a master degree holder with a broad knowledge on Tuberculosis control strategies
- Should have minimum of 5 years’ experience in carrying out public health assessments or surveys especially in the perspectives of tuberculosis programme
- Knowledge of Somalia NTP programme would be an advantage
- Have excellent knowledge of both written and spoken English
- Must be computer literate
- Must be familiar with Somali cultures, norms and customs
6.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.
7.TIME FRAMES
Activity
Location
Timeframe (days)
Nairobi meeting the GF PR team and health partners Nairobi -2
Recruitment and training of enumerators Somalia- 5
Collection of information Somalia -10
Analysis Nairobi -4
Preparation of Draft report Nairobi 3
Assimilation of comments Nairobi -2
Final Report Nairobi 4
Total number of days is 30
How to apply:
Kindly submit your technical proposal for this scope of work tosomo_supplychain@wvi.orgby 25th September 2016.