Consultant (Individual Consultant/Private Firm) – Project HOPE The people to people health foundation Inc. Vacancy Announcement

Expression of Interest to carry out “Documentation of Lessons and Evaluation of cDSDM Implementation.”

1. Background

Ethiopia has made significant strides in reducing human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) incidence and overall epidemic control. AIDS-related deaths and infections reduced with the concerted effort of all stakeholders. However, the epidemic continues affecting sizable number of the population.

2.  USAID CHCT Activity

Project HOPE in partnership with different international and local implementing partners, has been implementing the USAID Community HIV Care and Treatment (CHCT) activity since 2017. During the past six years, the activity has significantly contributed to the areas of HIV treatment, care and support through direct service delivery, and providing technical assistance to local implementing partners. The activity built the technical and organizational capacities of local partners and the GOE.   Among the multitude areas of support, introduction and scale up of community based differentiated service delivery models (cDSDM) was a major undertaking that has helped more than 24,000 PLHIVs.

Differentiated Service Delivery (DSD) is a client-centered approach that simplifies and adapts HIV services across the continuum to reflect the preferences, expectations and needs of people living with and vulnerable to HIV, while reducing unnecessary burdens on the health system. DSD supports shifting resources to clients who are the most in need by supporting stable clients to have fewer and less intense interactions with the health system. Appointment spacing model, healthcare worker managed community-based ART refill model, community-based peer led ART refill model and the Fast Track ART refill models have been implemented for some years now. Currently, two community-based ART refill models, i.e., the urban health extension professional-managed community ART refill group (UHEP/HEP_CAG) and the peer lead community-based ART distribution model (PCAD) are implemented in Addis Ababa, Gambella, Amhara, Oromia, SNNP, Sidama, and South-West Ethiopia People’s regions. By the end of March 2023, there were 223 ART sites actively implementing HEP-CAG & P-CAD (at least one group formed). A total of 24,915 clients were enrolled to C-DSDM of which 10,800 (43%) were enrolled to HEP_CAG and 14,115 (57%) were enrolled to PCAD.

3.  Purpose of the consultancy

Project HOPE is looking for a consultant or firm to review cDSDM implementation and document the lessons across the target regions under USAID CHCT activity, and to evaluate its impact on patient health outcomes including treatment adherence, viral suppression, and retention in care. This consultancy is expected to focus on the implementation of HEP_CAG and PCAD as part of the community-based HIV care, and treatment (CHCT) activities.

4.  Scope of the assessment

The evaluation assessment will follow a cross sectional survey design utilizing both quantitative and qualitative methodologies. It will be conducted through interviews, on site observations and systems reviews with RHB focal persons, Sub-city focal persons, cDSDM implementing Health Facility focal persons, Health Extension Professionals, ART focal persons, Community Engagement Facilitators, PLHIVs, PLHIV peer support group leaders, case managers and adherence supporters found in the project target towns. The consultant/firm will develop an evaluation design/protocol applying both quantitative and qualitative approaches. The consultant/firm will develop a protocol which is suitable enough to answer the evaluation questions mentioned under the objective below. The consultant/firm is also expected to develop and submit data collection materials including structured questionnaires, checklists, and open-ended questions for KII and FGD. In addition, the consultant/firm must respond to comments of peer reviews and collaborate with the M&E/Program staff and Research, Learning, and Publication (RLP) team of Project HOPE.

5.  Objectives of the evaluation

5.1. General Objective

• To document the lessons learnt and to evaluate the performance of C-DSDM models and its impact on patient health outcomes: viral load suppression, treatment adherence, and retention in care.

5.2. Specific Objectives

• To assess the implementation of C-DSDM in PEPFAR-supported regions including in Addis Ababa, Amhara, Oromia, SNNP, Sidama, South-West Ethiopia, and Gambella regions.
• Assess the performance of C-DSDM against yearly targets.
• Evaluate the effect of C-DSDM on patient health outcomes: in terms of achieving VL suppression, improving adherence, and retention in care.
• Assess the benefits and drawbacks of implementing c-DSDM from PLHIV, implementer (LIP), and provider (HEW, CEF) perspective.
• Identify and summarize key implementation challenges.
• Document best practices and the lessons learnt.

6.   Methodology

The evaluation should follow scientific approaches including both quantitative and qualitative methods. The consultant or firm is expected to develop rigorous methodology to undertake the study in line with the above-mentioned objectives and purposes. These will include defining the sample size calculation, sampling techniques and recruitment of respondents, data collection and analysis tools, processes, and procedures.

Evaluation sites: C-DSDM service delivery sites in Addis Ababa, Gambella, Amhara, Oromia, SNNP, Sidama, and SWEP regions.

Period of the consultancy: 08 Weeks (July – August 2023)

The consultant/firm should submit the detailed breakdown of the activities and timetable based on the following major activities as a guideline or suggestion:

• Finalize sample size calculation, sampling techniques and sampling frames in consultation with CHCT technical team.
• Prepare data collection instruments including questionnaires and qualitative guides.
• Training for data collectors, supervisors, coordinators including field practice/pre-testing.
• Field data collection data analysis and report writing.
• Preparation and submission of the first draft report.
• Debrief with project staff on the key findings.
• Incorporation of comments and finalization of the report.

 Sample size: adequate number of samples from each region.

Sampling procedure: random selection of subjects using patient records as a sampling frame.

Data collection methods: interviews using a questionnaire and checklist for quantitative data collection, and desk review, KII, FGD, and observation for the qualitative data collection. The consultant may propose additional data collection and data quality assurance methods. Data collection using mobile/electronic devices would be a plus.

 7.   Major tasks /activities of the consultant

• Participate in briefing meetings on the assignment with CHCT team of Project HOPE.
• Submit inception report (protocol) that details the methodology and other key aspects of the evaluation including, but not limited to, the detail sample size calculation and sampling techniques, key indicators to measure, tool development process and schedule; evaluation staff recruitment, training and deployment plan; data collection logistics; data quality assurance during data collection; data entry plan including quality assurance during data entry; data analysis plan, syntax and report.  Moreover, it should also include proposed tools for data quality assurance and proposed report outline and dummy tables.
• Meet with CHCT team to discuss and address comments on inception report and the other key deliverables (see next section).
• Develop the data collection instruments in line with the activity’s core outcome indicators.
• Recruit supervisors and enumerators as per the plan detailed in the inception report.
• Train the evaluation team on the questionnaire and implementation.
•  Oversee the data collection process to include: pre-test and ensure effective management of data collection teams by supervisors.
• Assure the data quality through proper supervision, questionnaire reviews, interview spot checks, daily discussion with data collection team on problems encountered and other data quality assurance methods detailed in the inception report.
• Enter the data using appropriate package, clean and analyze per the agreed plan.
• Prepare weekly progress reports.
• Produce and submit to CHCT team draft report on findings (per required format and data request).
• Incorporate comments from the team into draft report and produce final report.
• Finalize a high-quality report.
• Present findings to the CHCT team after the report submission
• Coordinate with the CHCT Team to disseminate study findings to stakeholders.

8.   Major Deliverables

• Evaluation inception report including proposed dummy tables.
• Reviewed and finalized data collection tools and checklists.
• Key informant and in-depth interview guides and checklists.
• Brief report of the field data collection process that outlines issues and challenges that may need to be considered in interpreting the final report within one week of completing the data collection.
• Debriefing meeting with CHCT technical staff based on the field data collection process report mentioned above.
• Submission of preliminary findings within two weeks of field survey completion followed by briefing meeting with CHCT staff.
• Data entry template and syntaxes generated for cleaning and analysis.
• Final cleaned datasets in STATA/SPSS.
• Evaluation team name and contact details.
• Evaluation route plan, checklists prepared for the evaluation, data quality assessments tools in the field, data management manuals, datasets codebook and dictionary,
• Draft report for review based on the outline agreed in the inception report.
• Final report based on the outline agreed in the inception report.
• Concise final report not more than 40 pages (Excluding annexes), in three hard copies and word document.
• Power-point presentation for dissemination purpose.
• Present the evaluation findings at a national dissemination workshop organized by CHCT within one month of submitting the final report.

9. Ethics, and Code of Conduct

• As the consultant/firm will be working on behalf of Project HOPE, they will be required to adhere to the ethical standards of the host country.
• The evaluation protocol will make clear to all participating stakeholders that they are under no obligation to participate in the evaluation and should obtain informed consent for their participation. All participants will be assured that there will be no negative consequences if they choose not to participate. Participants must be assured of the anonymity, confidentiality and protection of visual data and its use for agreed purpose only.
• Bidders are expected to implement sound and ethical judgement in their undertakings all through the procurement cycle. Misrepresentation of facts will not be tolerated.10.  Cost and Logistics

  The consulting Firm will be responsible for arranging all the required logistics and related costs to conduct this assessment.

  11. Financial Proposal and payment schedule

  Financial proposals must be expressed in detail, and all cost components must be included. Please note that the overall contract amount will remain fixed incase changes are made in the cost components. All travels and per-diem for data collectors related to this consultancy work will be covered by the consultant/firm. The contractor will be paid an all-inclusive fixed lump sum amount over the assignment period per the following payment schedule:

  • 30% of the total amount will be paid after signing the agreement,
  • 30% after submission of the first draft
  • 40% shall be paid after successful completion of deliverables.

  12. Submission of proposals:

  • Details of the technical and financial proposals should be submitted in a separate sealed envelope. Or the applicant can submit both proposals in PDF file to the following e-mail address: etesfaledet@projecthope.org.
  • Cover letter: A one-page cover letter indicating the name, mailing address, telephone number, official stamp, and signature of the applicant should be included in the proposal.
  • Annexes: Any additional document including CV, previous work experiences, and other relevant documents may be attached as annex.

  13. Evaluation Criteria:

  Proposals will be evaluated by the selection committee based on the following criteria:

  a.       Illustrative Technical proposal (70%)

  • Understanding of the Scope of the project (10%)
  • Quality and clarity of the illustrative technical approach/concept in relation to the TOR (10%)
  • Proposed methodology: Clarity and feasibility of the methodology (30%)
  • Organizational expertise in technical and operational aspects (10%)
  • Successful experience undertaking similar work (10%)
  • Qualification and experience [10%]

  b.       Financial Proposal (30%)

  The financial proposal will be considered only if the technical proposal assessment score is > 50 (out of 70).

  All the experts mentioned in the technical proposal should be available during the evaluation. If the consultant wants to change any of them, Project HOPE should be formally communicated in advance for approval. Potential applicants may be requested for a ~30 minutes presentation and ~30 minutes discussion.

• The consultant/firm should demonstrate expertise and experience in project evaluation.
• Familiarity with HIV/AIDS prevention, care, and treatment services, and experience in DSD models will be highly preferred.
• Familiarity with the application of mobile devices for individual beneficiary-level data collection.
• Proven experience of carrying out quantitative and qualitative studies focusing ideally on HIV/AIDS and related issues.
• Capacity to work within a specified period to complete all the base line study activities and report to Project HOPE as agreed.
• Lead consultant should have a minimum of master’s degree in related discipline including Public Health, Medicine, Epidemiology, Statistics, Health/Biomedical sciences, and Monitoring and Evaluation.
• The following key competencies are expected to the minimum:

o   Data collection, analysis, and write-up.

o   Experience in conducting implementation research

o   Experience on mobile-device applications, such as CommCare.

o   Practical skills and experience on data analysis using STATA, SPSS, NViVO, DEDOOSE, and other software.

o   Working knowledge of DHIS-2.

• Language requirements: Expert knowledge of English is required. Knowledge of local official language/s would be a plus.