A. Study background. Page 2 of 6

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1 Terms of Reference Feasibility Study: Innovative approach to improved Management of Non- Communicable Diseases in the informal settlements of Nairobi, Kenya. June 2016

2 A. Study background Malteser International is the worldwide relief organization of the Sovereign Order of Malta for humanitarian aid. The organization has more than 50 years of experience in humanitarian relief and covers about 100 projects in currently operative in about 20 countries in Africa, Asia and the Americas. In Africa, Malteser International is involved in 4 countries: DR Congo, Uganda, Kenya and South Sudan. Our mission is to alleviate human suffering. In Kenya, Malteser International has been working since 2001 in the areas of Tuberculosis, HIV, PMTCT, Water Sanitation and Hygiene (WASH) where the focus has always been bridging the interface between the community and health facility by strengthening the capacity of the communities. Other key areas of intervention include response to emergencies and use of innovative technologies in programming. Malteser International works in line with the government systems and in partnership with other partners including AMREF Kenya to offer trainings to Health care Workers; National TB and Leprosy Program; National AIDS and STI Coordinating program (NASCOP); Kenya Medical Supplies Association in supply of essential drugs to Health facilities among others. Malteser International has a team of staff with expertise in Monitoring and Evaluation in the health sector who supports the partner organisations through capacity building. Malteser International has recently handed in a proposal with the German Ministry for Economic Development to enhance Strategic Information Capacity for Health Programs in Nairobi, Kenya through use of Electronic and Mobile Health Solutions in Monitoring and Evaluation. The project goal is to improve the health care system through strengthened human resources for health capacity in clinical and data management of selected Noncommunicable diseases in Nairobi County. The project will use an innovative technology to build the capacity of healthcare workers to adhere to clinical guidelines in management of Hypertension and Diabetes Mellitus. The system commonly referred to as paper-based EMR system will provide a platform to easily digitalise data leading to improved data quality, ease in data analysis and reporting on NCDs. In addition the project will foster a strong public-private partnership by engaging both sectors in project delivery. The feasibility study is required to be conducted before the start of the project as part of the Programming phase to ensure at an early stage in the Project Cycle that support is based on a realistic assessment of the problems, opportunities, priorities and constraints and ensure a maximum of effectiveness, efficiency and sustainability. Page 2 of 6

3 B. Study objectives The study will give sufficient background information and justifications to enable the Malteser International and envisaged Donors like BMZ to make an informed decision on future cooperation. The study should facilitate the continuous dialogue between the partners and improve the participation of all stakeholders in this process. This will strengthen the country s capacity to take sound decisions to improve the health services for non-communicable diseases like Hypertension and Diabetes Mellitus. C Study results The study will deliver the following: i. background information on social and health context, with special emphasis on informal settlements of Nairobi ii. description of the technical component (constraints and opportunities) iii. rationalisation on financial aspects iv. definition of policy and operational constraints which need to be resolved before assistance can be initiated v. Recommendation for the next steps and further action to be taken The final study report will not exceed 20 pages excluding appendices. The report will be in English and 2 copies will be submitted to Malteser International by 30 th of June The study will include an executive summary that provides a general description of the feasibility study and highlights the findings of the feasibility study, containing the following issues: The problem analysed in the feasibility study The project objectives Expected impact Expected costs and benefits Anticipated risks D Issues to be studied The main issues to be studied are outlined below. I. The analysis will include an assessment of macro-economic setting, development objectives and policies; including access to health services in the informal II. III. IV. settlements of Nairobi Current and estimated future demand and supply of health service for noncommunicable diseases An analysis of non-communicable disease data management, identifying the main characteristics and contribution to decision making and improving quality on health services. the principal stakeholders, their roles and interests, and possible conflicts between these stakeholders; Page 3 of 6

4 V. Institutional settings and processes; VI. relevant revenues and financing; VII. An assessment of the possibilities and mechanism for improved coordination and coherence with on-going and planned assistance from the public health system, other bilateral and multilateral donor agencies and international financing institutions. This will help to avoid overlaps and improve the efficiency of external assistance. VIII. An assessment of policy (including legal), institutional and operational constraints to the co-operation in the non-communicable disease areas and the health sector in general. E. Work plan On the basis of the proposed time schedule outlined in the Terms of Reference, the consultants will prepare a work plan for the study and include this in their offer, and report on the approach taken in the study. The work plan should set out the consultants approach to the following activities: fact finding/data collection/surveys; consultations and other means of ensuring local participation; identification of possible options for the proposed [public health data management]; analysis of options; a briefing report summarising the analysis of the options; consultation meetings with decision makers to identify the preferred option; Preparation of the draft and final pre-feasibility study report. F. Expertise required The expert should demonstrate experience in elaborating feasibility studies for development projects work with public health sector, preferably with health data management experience with innovative, digital data collection and management methods desirable analytical competence good writing skills G. Time schedule The consultants should respond to this timetable in their offer, indicating whether and how they can adhere to or improve on it. The proposal should submit a study timeframe showing the key work activities and in accordance with the dates specified below: Event Date Deadline for submission of proposals 16 June 2016 Proposal decision 17 June 2016 Page 4 of 6

5 Contract awarded 20 June 2016 Progress report 27 June 2016 Final study report and recommendations 30 June 2016 H. Assistance to the consultants by the Contracting Authority Prior to the commencement of the project, consultative meetings will be held with the Malteser International Country Coordinator, Program Health Manager, and Senior Cluster Manager HQ, in order to discuss and agree on the Terms of Reference, and to clarify any other issues. Malteser International will make available all relevant reports, documents, maps, data to the consultant. I. Instructions to bidders Evaluation criteria Proposals will be evaluated on the following criteria: Ability to conduct key consultations and work with Malteser International to recommend financial schemes; Expertise in public health data management processes, preferably digital methods Representation/presence in Kenya (desirable for short timeframe); Price; Timeframe. The proposals will be evaluated by a review committee composed of representatives from Malteser International. Bidders background Bidders are kindly requested to include a short summary of past relevant work, achievements and references. Terms and conditions There are no specific format and headings for the submission of proposals. Proposals and subsequent study reports should be drafted using the English language; Proposals shall indicate an appropriate price schedule and all prices shall be quoted in US dollars. Proposals should not exceed 10 working days. Malteser International will make no payment and no reimbursement of expenses related to the preparation of proposals. Malteser International may at its own discretion extend this deadline for the submission of proposals. Page 5 of 6

6 The final selection of proposals will be in accordance with the proposals evaluation procedures of Malteser International. Submission of Proposals The deadline for submission of proposals is 16 June The proposal should be sent per with concern Feasibility NCDs Nairobi to the following address: Page 6 of 6