Terms of Reference
Application to be sub recipient for the Global Fund 2022 – 2023 TB Grant
Federal States of Somalia
Reducing TB incidence and TB related mortality among Somalis
January 2022 – 31st December 2023
- See Annex 2 (page 7).
Programme Focal Point
Chief of Party Global Fund TB Program, World Vision International,
National TB Program Manager.
Sector and Area of Specialization:
Support MOH in carrying out the following TB related services
§ Conduct TB diagnosis and treatment
§ Monitoring of TB patients according to TB management guidelines
§ Management of Latent TB Infection (LTBI)
§ Active TB case approaches including
- Contact tracing of presumptive cases
- Outreach for awareness and TB stigma reduction, TB screening – especially in key populations
- Effective collaboration with private sector in TB services
- Increase in Community Case detection through working with Female Health Workers
§ Participate in Laboratory External Quality Assurance
§ Effective management of Pharmaceutical and Health Products
§ Implement DHIS2
1. Background and Rationale for the Program
Three decades of civil war and instability, coupled with continual humanitarian crises such as drought and floods, have weakened Somalia’s health system and contributed to some of the poorest health indicators in the world, including very low coverage of essential health services, lack of access to hygiene and sanitation, malnutrition, high burdens of communicable and noncommunicable diseases, high infant and maternal mortality and very low life expectancy (WHO, 2020).
This is concurrently compounded by insecurity in some areas, weak service delivery capacity and fiscal capacity constraints.
Tuberculosis in Somalia remains a major public health concern. Though the incidence of TB has declined from 286/100,000 in 2010 to 258 per 100,000 population in 2020, TB treatment coverage is still low and TB case notification is estimated at 42%. However, the program has maintained high treatment success rate, with an average of 90% among newly diagnosed TB patients over the last 10 years.
MDR TB burden incidence is estimated at 27 per 100,000. This translates to more than 4000 annual MDR-TB cases. With these estimates, the country is one of the 30 highest burden countries in the world where the absolute number of incident cases meets the minimum threshold level of 1,000 incident cases per year.
While MDR TB treatment coverage increased 10-fold in last 6 years with rollout of 3 MDR TB management sites and introduction GeneXpert machines for diagnosis, the case notification remains below 15% of annual incident cases.
The current TB grant funded by the Global Fund for the period of January 2021 – December 2023 is built upon successes and lessons learned of the previous TB grants in Somalia and aims at scaling up the fight against TB in the country and achieving the goals outlined below.
2. Goals, Strategies and Activities
§ 50% reduction in TB deaths (compared with 2015)
§ 30% reduction in TB incidence rate (compared with 2015)
§ >20% affected families facing catastrophic costs
§ To increase TB case detection, and ensure treatment completion of all forms of notified drug susceptible TB cases from 16,918 in 2019 to 27,000 by 2023, while increasing the treatment success rate from 86% in 2017 to 90% by 2023.
§ To increase the number of RR/MDR TB cases enrolled on treatment from 335 in 2019 to 1044 in 2023 while increasing the treatment success rate from 79% in the cohort of 2016 to >85% in the cohort of 2021.
§ To ensure all diagnosed TB patients are tested for HIV and are aware about their HIV status. In addition, increase the proportion of TB/HIV coinfected patients on ART to >90% by 2023 from existing 72% in 2019.
§ NTP program management capacities improved at all levels (coordination, monitoring and evaluation, data collection and exploitation for planning, execution of operational research.
§ The proportion of patients (children under five, HIV patients without TB disease, respectively) initiated on TPT increased to 80% in 2024.
§ Further integration of the standalone TBMUs into health facilities.
§ Development of the capacity of the government in the financial, programmatic and procurement aspects.
§ Focus on improvement of use of data (HMIS)
§ Increased testing and improvement of the samples transportation networks.
§ Strengthening of the community component through expansion of the FHWs network.
§ Ensuring 100% TB treatment coverage.
§ Improved human rights and gender strategy.
§ Implementing PPP strategy.
§ Decentralization of MDR TB management
2.4 Key activities:
§ Case detection and diagnosis including contact tracing and LTBI.
§ Treatment and care.
§ TB/HIV co-infection management
§ Contact tracing
3. Target Group/Beneficiaries
§ People who require access to the TB services including women and children
§ Internally displaced persons and migrant populations
§ Prison populations
Expression of Interest.
Interested organisations are invited to apply for consideration to be sub recipients for TB grant implementation. Further relevant information and guidance on the application, selection and expectations from successful applicants is provided in other sections of this ToR below.
14th November 2021
Notification of Result
28th November 2021
Estimated Start Date
1st January 2022
Estimated End Date
31st December 2023
Mandatory and additional documents
Applicants must submit the following Mandatory documents as part of the application package:
· Registration with National and Sub National Authority.
· Proven experience with the National TB program.
· Tax compliance certificate
· Organizational profile- must include management structure.
· Identity and constituency of the organisation;
· Governance and Leadership;
· Strategy Systems and Structure;
· Managing Resources;
· Implementation of projects; and
· Working with partners
Key selection Criteria
In addition to the assessment results, the criteria below will be taken into consideration, while selecting successful candidates:
· Cost effectiveness (5%)
· Local experience and presence (10%)
· Relevance of proposal to achieving expected results (15%)
· Sound technical experience and sector expertise based on the relevance and appropriateness of proposed interventions (20%)
· Clarity of activities and expected results (5%)
· Proven track record of good financial management and good audit results.(20%)
· Contribution of resources.(10%)
· Demonstrated capacity to reach Key vulnerable population.(10%)
· Overall risk rating (5%)
§ Relevant members of the GFSC will be part of the selection of a successful applicant.
§ Applicants should demonstrate previous experience on TB services and key populations.
§ Applicants should demonstrate previous health service provision experience, and partners worked with.
§ Applicants must provide proof of registration to work in the regions they propose to work in.
§ Applicants are expected to submit one proposal for each federal state.
§ Applicants should quantifiably indicate what they will bring to the program.
§ Applicants must be willing to amend their proposal as required during the implementation period.
§ Successful applicants are expected to report on-time on a quarterly basis as per World Vision and Global fund sub-recipient reporting guidelines. The NTP is the point of all report consolidation.
§ Successful applicants will require an MoU with Government Authorities before entering agreement with the Principle Recipient.
§ An agreement between the successful applicant and the Principal Recipient will need to be signed before implementation of activities.
§ The Global Fund Steering Committee (GFSC) has oversight responsibility of the grant supporting these activities and thus these activities. The oversight committee of the GFSC is comprised of various stakeholders, including MoH.
§ The National TB Programme and World Vision will have supervision responsibilities over activities outlined in this ToR.
Work Plan, Targets and Expected Results
§ The workplan template with prepopulated activities/deliverables will be shared with successful applicants.
§ The targets will be discussed and filled in the template according to the number of TBMU/Hospitals allocated to each sub recipient.
§ While the Expression of Interest is being advertised broadly for the locations listed below, the Ministry of Health given their leadership role in TB Treatment and Care, will ultimately assume implementation responsibility of select the final implementation sites for the successful applicant, this negotiations will take place at the time of contracting.
How to apply
§ All documents pertaining to the advertisement to be sent solely to the email addresses below:
ANNEX 1. OVERSIGHT, SUPERVISION AND REPORTING LINES
Overall Grant Activities Oversight – Global Fund Steering Committee
TB Grant Oversight – PR
Field Oversight – Government & PR
PR – Implementing Partner – NTP
GFSC LFA GFCT
PR WHO MoH
Annex 2: TB Management Units / Hospitals and their Locations
S/No TBMU/Hospital State
- Benadir Banadir
- Central Prison Banadir
- Daynile Banadir
- Dhakinley Banadir
- Madina Banadir
- Mogadishu Abdiaziz Banadir
- Mogadishu Ayan-Hodan Banadir
- Mogadishu Bulo/Hubey Banadir
- Mogadishu Waberi Banadir
- Mogadishu Yaqshid Banadir
- Abudwak Galmudug
- Adado Galmudug
- Dhusamareb Galmudug
- Eldere Galmudug
- Galkayo South Galmudug
- Guriceel Galmudug
- Haradere Galmudug
- Herale Galmudug
- Hobyo Galmudug
- Adale Hirshabelle
- Balcad Hirshabelle
- Beletweine1 Hirshabelle
- Beletweine2 Hirshabelle
- Bulomarer Hirshabelle
- Buq Aqaba Hirshabelle
- Daarasalam Hirshabelle
- Daryel B/burte Hirshabelle
- El Ali Hirshabelle
- Jalaqsi Hirshabelle
- Jowhar Hirshabelle
- Mahaday Hirshabelle
- Mahas Hirshabelle
- Merka Hirshabelle
- Qoryoley Hirshabelle
- Afmadow Jubaland
- Baradhere Jubaland
- Belet-Hawa Jubaland
- Bualle Jubaland
- Dhobley Jubaland
- Dollow Jubaland
- Jamame Jubaland
- Jilib Jubaland
- Kismayo1 Jubaland
- Kismayo 2 (MCH) Jubaland
- Luuq Jubaland
- Elwak Jubaland
- Garbaharey Jubaland
- Bandarbeyla Puntland
- Baargal Puntland
- Badhidhin Puntland
- Bosaso Puntland
- Burtinle Puntland
- Dhahar Puntland
- Eyl Puntland
- Galdogob Puntland
- Galkayo North Puntland
- Garowe Puntland
- Iskushuban Puntland
- Jarriban Puntland
- Qardo Puntland
- Mogadishu Bondeere Mogadishu/Hamar jab jab/Banadir
- Afgoye South west
- Baidoa South west
- Barawa South west
- Bayhawa South west
- Burhakaba South west
- Huddur South west
- Tiyeglow South west
- Wajid South west
- Wanlaweyn South west
How to apply
All documents pertaining to the advertisement to be sent solely to the email addresses below: