TERMS OF REFERENCE (TOR) SOS MOTHER AND CHILD HEALTHCARE PROGRAMME QUALITY IMPROVEMENT TRAINING ASSIGNMENT – Mogadishu, Somalia

SOS MOTHER AND CHILD HOSPITAL, MOGADISHU

SOS MOTHER AND CHILD HEALTHCARE PROGRAMME QUALITY IMPROVEMENT TRAINING ASSIGNMENT

TERMS OF REFERENCE 

1. 1. INTRODUCTION

SOS Children’s Villages (CV) Somalia has been running its operations in Somalia since 1985 when the first SOS Children’s Village was opened in Mogadishu. Despite the ever-changing political and social instability and constant high level of insecurity, SOS CV Somalia has maintained continuous presence in the country in general and in Mogadishu in particular. Programs/projects were later expanded in Somaliland (North- West Somalia) that included a Children’s Village, Medical Centre, Schools and Family Strengthening Program. In South Central Somalia, where the humanitarian situation is in crisis, SOS CV Somalia is implementing Health, Nutrition and Emergency Programs in Bay, Bakool, Middle Shabelle and Banadir regions.

Target beneficiaries for health services are community members, especially children under five years and pregnant women and lactating mothers from socially and economically marginalized backgrounds who cannot afford health care provided elsewhere. SOS CV services which include health and nutrition care are delivered free of charge.

The nutrition programme targets severely malnourished children 6-59 months of age and pregnant and lactating women. Severe acute malnutrition is diagnosed according to international and Somali Nutrition Cluster guidelines. Pregnant women are eligible from their 2nd trimester, and lactating women if they have a breastfeeding infant below 6 months of age. The supplementary feeding programme targets moderately malnourished children.

The principal objective of the programme is to provide; Integrated Emergency life-saving Health and Nutrition support for most vulnerable populations affected by conflict, natural disasters (floods/drought) and disease outbreaks in South Central Somalia

2. 2. BACKGROUND TO THE ASSIGNMENT

Quality health services are a product of both the wider health systems environment and the actions of providers and individuals working within the system. The Sustainable Development Goals stress that quality is a key element of universal health coverage (UHC). SDG target 3.8 calls on countries to achieve UHC, including financial risk protection alongside access to quality essential health care services. Between 5.7 and 8.4 million deaths are attributed to poor quality care each year in low- and middle-income countries (LMICs), which represents up to 15% of overall deaths in these countries. Sixty per cent of deaths in LMICs from conditions requiring health care occur due to poor quality care, whereas the remaining deaths result from non-utilization of the health system. Inadequate quality of care imposes costs of US$ 1.4–1.6 trillion each year in lost productivity in LMICs. In high-income countries, 1 in 10 patients is harmed while receiving hospital care, and 7 in every 100 hospitalized patients can expect to acquire a health care-associated infection. It has been estimated that high quality health systems could prevent 2.5 million deaths from cardiovascular disease, 900 000 deaths from tuberculosis, 1 million newborn deaths and half of all maternal deaths each year. Globally, the essential structures for achieving quality care are inadequate: one in 8 health care facilities has no water service, one in 5 has no sanitation service, and one in 6 has no hand hygiene facilities at the points of care. An estimated 1.8 billion people, or 24% of the world’s population, live in fragile contexts that are challenged in delivering quality essential health services. Somalia falls in fragile states category and has some of the worst health indices globally. A large proportion of preventable maternal, childhood and neonatal deaths occur in these settings

In Somalia quality of health care is influenced by a variety of factors: health infrastructure, health provider skills, weak health system, governance and leadership challenges, devices & medical products, health workforce training, regulatory frameworks, overreliance on INGOs, financing gaps and wider fragile context. SOS Health & Nutrition program is not immune to these factors with staff skills, availability of medical supplies, infrastructure, infection prevention & control, safe medical waste disposal, regulatory frameworks and training quality all playing critical role better or worse patient outcomes. Patients, families and the community also contribute to successful patient outcomes. Despite this more than 6200 live births were delivered in 2020 alone and 130,000 people attended PHC services in the same period. The inpatient section attended to more than 12,800 in 2020 including 770 caesarian sections. The huge number of patients and relatives that walk through the gates of the HF pose major challenge related to maintaining hygiene, safety, security and risks to patients.

Whereas the quality of service is considered to be not among the worst in the region SOS health and nutrition program needs to design, implement and sustain quality improvement measures to scale up or maintain service quality to survive in an environment that is changing rapidly with better equipped, better staffed and better resourced hospitals cropping up in Somalia every day. To achieve this goal SOS Hospital plans to train key staffs to drive the quality improvement agenda in the hospital.

3. 3. OBJECTIVES

The overall objective of the proposed training is to train health workers and hospital management on quality improvement (QI) and cultivate QI culture in the hospital. The specific objectives are:

3.1 Assess participant & hospital QI capacities, knowledge & skills gaps

3.2 QI Training participants are able to design, develop, implement & evaluate departmental QI plans for the hospital for quality outcomes

3.3 Participants are equipped with the basics of QI science of improvements, approaches and methodologies

Equip participants with knowledge, skill & attitude to facilitate delivery of efficient high quality services based on QI models in practice.

Develop a simple monitoring and evaluation system for continuous tracking of the implementation of QI.

4. 4. METHODOLOGY

The Consultant will be expected to employ a blend of participatory training design and delivery techniques. These will include but not limited to pedagogic learning principles, lectures, group work, observation, open discussions and do-it-yourself.

5. 5. SCOPE OF WORK

The consultant is expected among other tasks to:

5.1 Assess QI knowledge, practice & practice, & QI measures currently in place and identify gaps/deviations from standard practice

5.2 Design appropriate training to improve staff’s knowledge, skills, attitudes and practices regarding

QI in health care

5.3 Train SOS health workers on principles and basics of QI and carry out on the job training for QI projects within the hospital

5.4 Help learners design, develop & implement QI systems or QI guidelines for the hospital for successful outcomes

5.5 Develop a simple monitoring and evaluation system for continuous tracking of QI in the hospital

6. 6. TIMEFRAME

The assignment will be undertaken within 6 months broken down as follows:

7.7. DELIVERABLES

The Consultant is expected to deliver the following outputs for this assignment:

7.1 Technical proposal and work plan outlining how the consultant intends to conduct the assignment

7.2 Within 5 days of inception, a report on findings from assessment of gaps/deviations with clear recommendations on way forward and training modules to address the identified gaps

7.3 Within 10 days of completion of training delivery a process training report complete with annexes of training schedule, a list of participants duly signed by each participant disaggregated by age, gender, profession and department as well as the

7.4 Developed Hospital QI guidelines

7.5 M&E system to track implementation of QI protocols in the hospital

8. 8. QUALIFICATIONS AND RELEVANT EXPERIENCE

Applicants must have:

• University degree in Health systems, Clinical Medicine, Medicine, Public Health, or any other related discipline
• Minimum of 2-3 years of practical experience in QI and capacity building
• Experience with emergency health and nutrition response programming including emerging response strategies
• Demonstrated understanding of hospital QI
• Excellent documentation and communication skills

9. 9. APPLICATION PROCEDURES

Interested Consultants who meet the conditions specified herein are invited to submit their technical and financial proposals including   proposed work plans, CVs of lead Consultant(s) and a clear demonstration of understanding and interpretation of this Terms of Reference (TOR) to procurement@sossomalia.org and indicate Quality improvement training in the subject line, to reach her not later than 31^st May 2021 at 3.30pm