DEVELOPMENT OF AN EFFECTIVE COSTED PLAN OF GENDER-RESPONSIVE INTERVENTIONS IN TB SERVICES

TERMS OF REFERENCE (ToR)

DEVELOPMENT OF AN EFFECTIVE COSTED PLAN OF GENDER-RESPONSIVE INTERVENTIONS IN TB SERVICES

Job Title:Consultancy -Development of an Effective Costed Plan of Gender-Responsive Interventions

Category:Gender and Human Rights

Duty Station:Federal Government of Somalia Member States and Somaliland

Type of contract: Short term Consultancy

Expected Starting date:1^st April, 2021

Duration of Assignment :One month

A. BACKGROUND

Tuberculosis burden

Tuberculosis (TB) is a communicable disease that is a major cause of ill health, one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. The disease typically affects the lungs (pulmonary TB) but can also affect other sites (extra pulmonary TB).

An estimated 10.0 million (range, 8.9–11.0 million) people fell ill with TB globally in 2019. Geographically, Africa accounted for 25% of the people who developed TB in 2019.

In 2019 the total number of TB cases notified in Somalia was 16,918, a number almost identical to that of to 2018 (16,673). Case notification rate has improved between 2009 and 2019 by about 50%; yet almost three fifths of the increase (30%) has to be credited to the natural population growth, the mean annual increase thus being about 2% (NTP/WV/WHO data).

For the year 2019, the World Health Organization (WHO) estimates the TB mortality rate in Somalia, including HIV+TB, at 170 (110-260) per 100k population.

Somali TB Program

TB control service provision is managed under the National Tuberculosis Programme (NTP) within the Ministry of Health (MOH). However, after the collapse of the central government in Somalia in 1990, TB control service provision have been implemented through key partners who consist primarily of international and national Non-Governmental Organizations (NGOs) with WHO providing the technical expertise in collaboration with Somali government. From 2004, TB control has mainly been funded by the Global Fund for AIDS, Malaria and TB (GFATM). World Vision Somalia (WVS) is the principle recipient.

Further, the government contributes to the implementation through provision of infrastructure, security support and facilitation of the implementing partners involved in the TB control.

Despite being at its infancy stage and the complex political and security in the country, the Somali government has made progress in TB control and management. Access to TB services has generally improved through an increase in the TB Management Units (TBMUs) and laboratory network for microscopy services implemented according to the Stop TB Partnership global DOTS strategy. With uninterrupted funding from the Global Fund since 2004, access to TB services and treatment have increased from 12 TBMUs in 1995 to 96 by December 2020. This number of TBMUs is even according to international standards low with one TBMU for 160,000 inhabitants. According to WHO Global Report 2018, the treatment coverage[1]in 2017 was 42%, meaning that about 20,000 active TB cases remained untreated. TB treatment coverage was even lower in MDR TB cases (14%). The treatment success rate for bacteriologically confirmed DS TB patients is about 86% below the 90% global target. MDR-TB treatment success rate is about 79%.

In 2019, the government finalized the development of the third National TB 2020-2024 strategic plan. This was followed by the completion of the 2021-2025 Monitoring &Evaluation (M&E) plan that will guide the implementation of the strategic plan. The Strategic Plan contributes to the Somali Health Policy goal of improving the health status of the population through health system strengthening interventions and providing quality, accessible, acceptable and affordable health services that facilitate moving towards Universal Health Coverage (UHC) and accelerate progress towards achieving the health-related Sustainable Development Goals (SDGs).

The new National Strategic Plan (NSP) 2020 -2024 has strategies that mainly focuses on enhancing access to Drug Sensitive (DS) and Drug Resistant (DR) TB services via integration of the TB program, to the extent possible, in general health services compounded by much closer collaboration with the private sector, and by strengthening the collaboration with the community, preferably with locally adapted activities.

The strategy further focuses on the strengthening of the laboratory network, on the Latent Tuberculosis Infection with a comprehensive Tuberculin Skin Testing component, and on the control of TB in key and vulnerable groups.

Finally, interventions and activities are proposed for strengthening advocacy, the M&E component, supervisions, the human right component, and operational research.

Without diminishing the TB control and management progress made in Somalia, TB program has not expanded as desired. There has been a slow progress in improving the existing infrastructure to increase their capacity as well as establishing new health facilities to meet the community needs and ensuring quality of the services. Required additional resources in terms of workforce, infrastructures, equipment and supplies have been limited. At present, the Global Fund supported TB program is implemented by World Vision International Somalia Program (WVS) working in with implementing partners. The Somalia Global Fund Steering Committee (GFSC) and the TB Coordination Team (TBCT) provide the Country Coordination Mechanism (CCM) for the program.

Gender, Human Rights and Tuberculosis

Tuberculosis (TB) is deeply rooted and highly prevalent in populations where human rights and dignity are limited. While anyone can contract TB, the disease thrives on the most vulnerable—the marginalized, discriminated against populations, and people living in poverty[2]. TB is preventable and curable, but current efforts to find, treat and cure everyone who gets ill with the disease fall short. Of the 10 million people who fell ill with TB in 2019, only 7.1 Million new cases were reported to have been newly diagnosed and notified[3]. Geographically, most people who developed TB in 2019 were in the WHO regions of South-East Asia (44%), Africa (25%) and the Western Pacific (18%). TB is a disease of poverty and inequality. Many factors related to human rights and gender can hinder the effectiveness, accessibility and sustainability of TB programs and services[4]. Economically disadvantaged persons are at a higher risk of contracting TB infection and developing TB disease. Additionally, they are likely to lack access to good-quality TB services and information about the disease. Other than economics, gender, TB/HIV co-infection, stigma and discrimination, nature of population (prison and mobile) and occupational risks are some of the Gender- and human rights-related risk of TB transmission and barriers to TB services.

Gender, Human Rights and Tuberculosis in Somalia

An explicit human rights and gender policy is lacking in Somalia^[5]. Whilst vulnerable underserved populations have been defined barriers have not been systematically removed to guarantee access to services. There has never been a TB focused gender assessment done. There is also no national network or support group engaged with the NTP for supporting persons affected by TB. There are however plans to include gender and rights in all trainings of NTP personnel.

Development of an effective costed plan of gender-responsive interventions

Costed plans are crucial for determining the financing gap and mobilizing resources to fill the gaps. In line with the Somalia NSP 2020-2024, World Vision, NTP and WHO Somalia seeks undertake and analysis, develop a strategy and a costed plan of gender-responsive interventions that will effectively address the most urgent gender and rights-based barriers and issues.

B. METHODOLOGY & PROCESS

Objective and Scope of Work

The main objective of the consultancy is to developa costed plan of gender-responsive interventions that will effectively address the most urgent gender and rights-based barriers and issues

Specific Objectives

The specific Objectives of the consultancy are:

· Undertake a community rights and gender (CRG) assessment and gender rights analysis

· Develop Gender Equality and Social Inclusion Strategy

· Develop a costed plan with gender responsive activities

Rationale of the consultancy

The documents will inform policy dialogue, planning and budgeting at both the national and sub-national levels. It will also guide budgetary needs informing projections, mobilization and sustainability of quality resources for cost-effective interventions that address the most urgent gender and rights-based barriers and issues. The report will also identify the key interventions needed to achieve a gender and human rights based approach to TB management in the Somalia region.

Scope of Focus

The assessment will cover the 3 National TB Programs (Somaliland, Puntland and Federal republic of Somalia) and involving partner organizations, community, and government stakeholders in these three regions.

Assessment region: Somalia

Assessment population: Partner organizations, Community and Government

Assessment duration: One month

The successful consultant, in close collaboration with World Vision and MoH will carry out the comprehensive analysis, develop the strategy and the costed plan of targeted interventions. The successful proposal will be reviewed by the technical research team before commencement of the exercise. A constant communication with World Vision will be ensured. The assignment report on the assignment will also be presented to the technical team before a final report is printed and submitted to World Vision for final approval.

Outputs/Expected deliverables

· At inception, the consultant is expected to submit a detailed inception report and plan on how the development process will be carried out including a comprehensive methodology.

· Detailed Gender Equality and Social Inclusion analysis, strategy and costed plan report

· Final consultancy report both in soft and 5 hard copies including all data sets used during the survey

Deliverables, reporting and project schedule **

1. Participation at the kick‐off meeting at World Vision Premises and the detailed report on the discussions and conclusion of the kick‐off meeting, including the key issues discussed and decisions made (to be delivered two weeks after the kick‐off meeting).
2. The updated project work plan for the entire duration of the contract, including general methodological approach, milestones and timelines in accordance with the objectives of the project and decisions of the kick‐off meeting.
3. The two‐page synopsis of the project outlining the general scope and purpose of the project to the relevant stakeholders for their information about the project (to be delivered two weeks after the kick‐off meeting).
4. The work plan, including assessment protocol, describing study design, methodological approach, analysis plan, expected outputs and timelines
5. Detailed high quality summary report on the assignment performed (to be delivered according to the approved project work plan or 1 moth before expiring of the contract).
6. High quality summary report on the assignment performed (to be delivered 1 month before the end of this contract).
7. A detailed report that should include review findings, realistic and achievable recommendations and next plan of action. The intended target audience for the reports are:

TB programme implementers and policy makers at national &international level as well as World Vision Somalia.

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 framework, results and analysis with FGS MoH and WHO Somalia once the consultant provides them.

1. Immediately after completion of the assignment, a summary report should be presented for discussion by the main stakeholders – (WV, MoH, GFATM, WHO).
2. Once this is agreed then the final report will be printed.

C. MANAGEMENT OF THE ASSESSMENT

While executing this assignment, the consultant and the parties involved shall be guided by the protocol summarized in the matrix below:

No

Stakeholder

Stakeholder / role

1

Consultant

Undertake the assignment based on the approved design and methodology and timeline

2

GF/PR technical team

Initiate the TOR and seek approval from WV

Lead the technical recruitment of consultant

Provide technical and managerial leadership to the consultant throughout the study process

3

WV QA / GF Technical team / NTP

Technical reviews to the ToR, Inception report, study design & methodology

Participate in the technical evaluation of consultants

Review draft report and recommend approval or non-approval

4

Supply Chain Manager

Advertise and complete bid selection processes. Site will be sahred with key stakeholders.

5

WV QA / GF Technical team / WHO / NTP

Review of the study findings

*Required Expertise and Qualifications

Education Qualification:

· Candidate must be a master’s degree holder preferably in Gender, Human Rights and Development, Community development or an associated degree

· A PhD degree in any of the fields above is an added advantage

Experience

· Competency in analysis, strategy and costed plan development.

· Knowledge on TB programming and reporting will be an added advantage

· Should have minimum of 5 years’ experience in carrying out development of program strategy and costed plans (Present 2 recent reports)

· Candidate with previous experience in conducting similar assignments in the region will have an added advantage

Language requirement and Corporate competencies

· Have excellent knowledge of both written and spoken English and be computer literate

· Familiar with Somali cultures, norms and customs

· Demonstrate integrity by modelling the World Vision’s values and ethical standards

· Ability to establish and maintain good working relations with colleagues in a multicultural environment.

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.

EVALUATION CRITERIA

Mandatory Requirements evaluation

a. Provide a certified copy of a certificate of business registration, Certificate of incorporation, business license or similar document (Companies/Organizations)

b. Provide a certified copy of tax registration, tax clearance certificates or similar documents (Companies/Organization)

c. Individual tax registration documents (for individual consultants)

d. Provide information on ownership structure (Name of directors of the company / Owner) (Companies/Organization)

e. Provide last two years of audited financial statements or tax filing, or similar documents (Companies/Organization)

f. Provide references from previous clients for similar works.(At least three)

Note – Applicant who will not meet the above mandatory requirement will not be considered for Technical Evaluation.

Technical Evaluation

Qualified and interested parties are asked to submit the following; **

Letter of interest in submission of a proposal

A detailed technical proposal clearly demonstrating a thorough understanding of this ToR and including but not limited to the following;

· Consultant/Company Profile**

· Description of methodology and sample size determination**

· Demonstrated previous experience in similar assignments and qualifications outlines in this ToR **

· Proposed data management plan (collection, processing and analysis)**

· Proposed timeframe detailing activities and proposed work plan**

· Team composition and level of effort of each proposed team member (Include CVs of each team member)**

Financial Evaluation

1. A financial proposal with a detailed breakdown of costs for the study quoted in United States dollars.
2. Payment Terms
3. Credit Period

Note:

As part of the Consultant selection process, the best candidates will be requested to prepare draft inception report and make a presentation of the same to the Global Fund Technical Team to inform the final decision on award of the Contract.

Application Process

All interested bidders/consultants are requested to submit their Technical Proposals and Financial Proposals in Separate documents as attachments (Bidders who will combine both technical and financial proposals shall be disqualified) via email somo_supplychain@wvi.org on or before **1^st April 2021*. Bids received after deadline shall not be considered.***

Email title should be;- DEVELOPMENT OF AN EFFECTIVE COSTED PLAN OF GENDER-RESPONSIVE INTERVENTIONS IN TB SERVICES

Your financial proposal should have your consultancy fees, payment terms and Credit period. Financial proposal should not be part of the technical proposal, it should be a separate document.

Provision of Taxation as per the Revenue Authority on Technical Fees:

A 5% withholding tax is levied on the payment of technical services fees (as well as professional and management fees) where the services are provided by a resident/resident firm in Kenya. If payment is done to an entity outside Kenya, relevant tax regulations will be applied.

The rate is 20% where the service provider is a non-resident/non-resident firm, unless an applicable tax treaty provides otherwise. Consultant firms must be able to demonstrate their tax compliance status at the time of bidding for this assignment as WVS will only engage with tax compliant individuals/firms.The proposal that complies with all the requirements, meets all the evaluation criteria and offers the best value for money shall be selected and awarded the contract. Any offer that does not meet the requirements shall be rejected.**

[1]Treatment coverage is the proportion of notified cases among the estimated incident cases.

[2] https://apps.who.int/iris/bitstream/handle/10665/66701/WHO_CDS_STB_2001….

[3] https://apps.who.int/iris/bitstream/handle/10665/336069/9789240013131-en…

[4] https://www.theglobalfund.org/media/6349/core_tbhumanrightsgenderequalit…

[5] Somalia National Strategic Plan 2020-2024