Request for Proposal (RFP) for Field Agencies to Implement. Health Facility Survey in Six States: Unintended Pregnancy and Abortion in India

Transcription

1 Request for Proposal (RFP) for Field Agencies to Implement Health Facility Survey in Six States: Unintended Pregnancy and Abortion in India 2015 Bid Document International Institute for Population Sciences (Deemed University) Deonar, MUMBAI Tel: Fax:

2 Key Events and Dates Tender Inviting Authority Job Requirement Announcement of Bids for Field Agencies International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai Appointment of Field Agencies for conducting Unintended Pregnancy and Abortion in India survey 15 December 2014 Last date for submission of bid 5 January 2015 Opening of bids 6 January 2015 Technical evaluation 7-13 January 2015 Opening of Financial bids 16 January 2015 Result Announcement 16 January 2015 (on IIPS website) Invitation for Proposal for Selection of Field Agencies- UPAI

3 Table A: LIST OF ACRONYMS ANM AYUSH B Pharma BAMS BE BHMS BTech BUMS CHC CMO DA DBMS DD DHO DLC EMD EVA FA FOGSI GFR HFS HPS IIPS IMA MBBS MCH MMA MO MoHFW MoU MTP MVA OB/GYN PAC PHC PMC PBC PO PRC RBI RFP SPO TA TAC TOT UFWC UHP Auxiliary Nurse Midwife Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy Bachelor of Pharmacy Bachelor of Ayurvedic Medicine and Surgery Bachelor of Engineering Bachelor of Homeopathic Medicine and Surgery Bachelor in Technology Bachelor of Unani Medicine and Surgery Community Health Center Chief Medical Officer Dearness Allowance Data Based Management System Demand Draft District Health Officer District level committee Earnest Money Deposit Electric Vacuum Aspiration Field Agency Federation of obstetric and gynaecological societies of India General Financial Rules Health Facilities Survey Health Professionals Survey International Institute for Population Sciences Indian Medical Association Bachelor of Medicine, Bachelor of Surgery Maternal and Child Health Medical Methods of Abortion Medical Officer Ministry of Health and Family Welfare Memorandum of Understanding Medical Termination of Pregnancy Manual Vacuum Aspiration Obstetricians/Gynaecologist Post Abortion Complication Private Health Centre Project Monitoring Committee Performance Bank Guarantee Project Officer Population Research Centre Reserve Bank of India Request for Proposal Senior Project Officer Travel Allowance Technical Advisory Committee Training of Trainers Urban Family Welfare Centres Urban Health Post Invitation for Proposal for Selection of Field Agencies- UPAI

4 Contents 1. INTRODUCTION Purpose of Request for Proposal (RFP) Background of the Study Specific Objectives and Scope of the Study Geographical Coverage Sampling Design and Implementation Project Planning and Management Execution and Implementation Public Health Facilities Private Health Facilities NGO/Trust Health Facilities (not for profit) Data Collection Procedure for the HFS SCOPE OF WORK Manpower requirement Attending TOT Workshops organized by IIPS Listing Exercise Training of the Trainers (TOT) IT training Listing exercise Public Health Facilities Private Health Facilities Trainings of Field Staff to be conducted by FA Major contents of the Health Facility Survey (HFS) Schedule Transportation Salary and DA for Interviewers Layers of Monitoring and Supervision

5 2.9 Listing and Survey State Level Field Office of Field Agency Data Collection for Health Facility Survey Data Management and Entry ROLES AND RESPONSIBILITIES OF FIELD AGENCIES Overall Roles and Responsibilities Assigned to Field Agencies IMPLEMENTATION SCHEDULE/TIME LINE FOR DATA COLLECTION PAYMENT SCHEDULE ELIGIBILITY CRITERIA for considering field agency for technical evaluation GUIDELINE FOR SUBMITTING PROPOSAL Technical Proposal Organizational Profile Survey Experience Financial Status of the Organization Proportional Allocation to Different Heads Financial Proposal Submission of Bids General Terms and Conditions EVALUATION OF PROPOSALS

6 1 INTRODUCTION 1.1 Purpose of Request for Proposal (RFP) The purpose of this RFP is to appoint Field Agencies (FA) for six states, Uttar Pradesh, Bihar, Assam, Madhya Pradesh, Gujarat and Tamil Nadu, for conducting the Health Facilities Survey (HFS) in the public, private, NGO/Trust sectors in these states. The purpose of the survey is to capture the incidence of induced abortions and the incidence of post-abortion complications. The survey will be conducted in the sampled public and private health facilities, representative at the state-level. The survey will also collect information on various factors related to abortion service provisions in these six states. A FA can apply maximum for two states, however, can get contract to carry out this study for only one state. 1.2 Background of the Study This study aims to fill an important gap in the evidence base by producing estimates for the year 2015 of the incidence of induced abortion and unintended pregnancy in India. Various social changes and changes in the accessibility of abortion in the recent past require that a study be conducted to capture the current trends and patterns of behaviour in this area. For example: Medical Methods of Abortion (MMA) has become more accessible and widely used, the average age at marriage is rising (possibly accompanied by an increase in premarital sex), levels of education are increasing, and the country is becoming more urbanized. These trends are generally linked to an increasing preference for smaller families and a greater need to prevent unintended births. However, the pace of increase in contraceptive use among married women has been quite slow during the past decade. More recently, policy responses to skewed sex ratios identified in the 2011 Census have resulted in surgical abortion services becoming less accessible in certain states. A combination of slow uptake of contraceptive services, combined with more inaccessible surgical abortion procedures might lead to an increase in women seeking, and being exposed to the risks of unsafe abortions. Across the world, it is usually difficult to obtain reliable data on abortion incidence directly from women, owing to the stigma surrounding abortion. In India, this is compounded by the illegality of sex-selective abortion. In response to this problem, the Guttmacher Institute, a non-profit research organization based in New York, USA, has developed a methodology to estimate abortion incidence indirectly, without having to interview women. This technique 7

7 has been validated across many contexts, including in countries similar to India, where both legal and illegal unsafe abortions are common. This study, which will estimate abortion incidence in India, is being conducted by the International Institute for Population Sciences (IIPS), Mumbai, and the Population Council, Delhi, in collaboration with the Guttmacher Institute, New York. The study will apply the methodology developed by the Guttmacher Institute. The application of this methodology depends on information obtained from two sources: the Health Facilities Survey (HFS) and the Health Professionals Survey (HPS). IIPS is the nodal agency to conduct the HFS in the six selected states. The number and classification of facilities to be surveyed are given in Annexure A. The Population Council, Delhi, will be responsible for administering the HPS, and this component is outside the scope of this RFP. A subsample of districts will be selected from each of the six states, and the survey will be conducted in both rural and urban areas of the selected districts, and will be administered in a representative sample of both public health facilities (Primary Health Centers (Block PHC, Additional PHC and Mini PHC), Community Health Centres, sub-divisional hospitals, district hospitals, medical colleges, municipal hospitals, and private health facilities (small, medium, large hospitals, nursing/ maternity homes and single person clinics) and NGO/trust hospitals and health centers. At each facility, we intend to interview the most knowledgeable individual who can speak about client flow at their respective health facilities: director/head of a health facility, medical officers (MBBS/BAMS/BHMS), obstetricians/gynecologists, specialist doctors (e.g. surgeons), ANMs (in few cases of PHC), public health nurses, etc. 1.3 Specific Objectives and Scope of the Study The objectives of this study are to: Generate high-quality data on the incidence of abortion and unintended pregnancy, the health consequences of unsafe abortion and the provision of abortion services and postabortion complication (PAC) care for the six selected states: Uttar Pradesh, Bihar, Assam, Madhya Pradesh, Gujarat and Tamil Nadu. Using the abortion incidence values generated for the six states will allow us to use mathematical models to obtain an estimate of abortion incidence for India as a whole. The project will document findings and suggest policy and program recommendations that will be released via a wide range of publications including to state and national stakeholders throughout India. 8

8 The survey will also provide information on several other issues including: Abortion services provided at different levels of health facilities in rural and urban areas in the country as well as in both public and private facilities, Types of abortion procedures provided based on gestation, Cost of abortion services in different types of facilities, and Level of contraceptive acceptance post-abortion. 1.4 Geographical Coverage The survey will be conducted across six states: Uttar Pradesh, Bihar, Assam, Madhya Pradesh, Gujarat and Tamil Nadu, covering about 45% of the reproductive age population of India. 1.5 Sampling Design and Implementation The study will be conducted in six states of India and the survey will be conducted in 171 sampled districts from these six states (70% from each state) using probability proportional to population size sampling. The HFS will be implemented and monitored district by district. FAs are responsible to conduct the facility listing and interview selected facilities in all the assigned districts. The districts defined here are to be considered as per Census 2011 status Project Planning and Management International Institute for Population Sciences (IIPS), Mumbai is the national level nodal agency to carry out activities under this study. Three major committees are involved in planning, implementation and monitoring these activities. A steering committee chaired by Additional Secretary, Ministry of Health and Family Welfare (MoHFW), Government of India has been set up to look into the overall planning, management and implementation as the apex level decision-making body for this study. A technical advisory committee (TAC) comprising representatives from academia, MoHFW, Govt. of India, and NGOs provides technical inputs to the study and tools of implementation. Another committee called the project management committee will take decisions on project progress, monitoring and implementation of the study. Faculty coordinators and representative from the Guttmacher Institute and sponsoring agencies will be the members of the committee. The committee will be chaired by the Director of IIPS, Mumbai. 9

9 1.5.2 Execution and Implementation The whole survey in all the six states is to be conducted in a single phase. The duration of whole survey fieldwork (listing and main survey) is around four months. The first activity will be a listing exercise, in which health facilities will be listed in specified areas following a specific data collection form. The second activity is the HFS survey of health facilities. Some facilities may be interviewed concurrently with the listing exercise, but other facilities will need to be interviewed after a lag of three weeks because data from the listing exercise need to be analyzed in order to select facilities for survey. At the time of listing, FAs are supposed to collect a set of critical information about provision of abortion and postabortion complication services. The detailed listing plan is elaborated in a forthcoming section of this RFP. A successful bidder will need to sign a memorandum of understanding (MoU) and complete all the financial obligations under the General Financial Rules of the Government of India before execution of any work assigned under the MoU. A broad range of responsibilities of the agency encompasses recruitment and training of staff (core staff: State Coordinator, IT Coordinator and Health/District Coordinator; field and monitoring staff); listing of different types of health facilities; printing a sufficient number of interview schedules, manuals and other study related formats, data entry; implementing the health facility survey; and data editing. FAs will need to send eligible and appropriately qualified persons to attend three trainings (listing, health facility survey and data entry) to be conducted by IIPS, Mumbai. Agency must keep filled-in interview schedules in a safe and secure manner as all filled-in interview schedules are to be returned to IIPS, Mumbai in the end of the contract. The returned of filled-in interview schedules in good condition will be one of the criteria to pay the last installment of the contract amount. The data entered in CSPro under this study must be sent on a daily basis through a secure . Agency will have to take all possible measures to maintain high quality data collected in this study and strictly follow monitoring feedback provided by IIPS, Mumbai. All the facilities that should be surveyed are classified in three categories-public, Private and NGOs/Trust. The rules for selection of intended sample size of HFS have also been given below. 10

10 1.5.3 Public Health Facilities a. All the district hospitals (DHs) situated in sampled districts (i.e. 171 districts) in six selected states will be surveyed. In the case of Uttar Pradesh, only female district hospitals in sampled districts will be covered in this study. b. All sub-divisional hospitals (SDHs) will be covered in sampled districts, except in Tamil Nadu. In Tamil Nadu, only 25 % of SDHs in selected districts will be surveyed in this study. c. One-third (33%) of the community health centres (CHCs) located in the 171 sampled districts will be surveyed, except in Bihar where 66% of the CHCs will be surveyed. d. Large publicly funded hospitals (state/centre/universities or those classified as Public Sector Units), other than district, sub-division hospitals and medical college hospitals, which have 30 beds or more and which offer abortions or have post-abortion complications providers/services in all sampled urban areas of 171 sampled districts will be surveyed in this study. This would also include those hospitals, which are funded by the ministries/ departments other than the Ministry of Health and Family Welfare either of the state or central governments. Similarly, large municipality-run hospitals that offer OBG/GYN services, in particular abortion or post-abortion complications services, will be included in all sampled urban areas. The selection of these facilities will be made by IIPS after the listing exercise is completed (on a district-by-district basis). Note : The number of these facilities are yet to be included in the total sample size in each state as provided in Annexure A. The payment for surveying these additional facilities will be made on the pro-rata basis based on the actual cost per facility quoted by FA in the bid. e. Urban Health Post/Urban Family Welfare Centres (UHPs/UFWCs) where a lady medical officer (OBS/GYN) is on staff in the sampled districts of the respective states will be selected. The selection of these facilities will be made by IIPS after the listing exercise is completed (on a district-by-district basis). f. Primary Health Centres (PHCs): Two PHCs supervised by each sampled CHC will be interviewed in the states of Madhya Pradesh, Uttar Pradesh, Gujarat, and Tamil Nadu. Three PHCs from each sampled CHC in Assam and six PHCs (Additional/PHCs) from each sampled CHC in Bihar will be surveyed. The selection of PHCs will be done by the field workers according to strict rules provided by IIPS. 11

11 g. All publicly funded medical colleges (Department where Abortion and PAC services are provided) which exist in the assigned states will be surveyed. Note that medical colleges from all districts will be included, not just the 171 sample districts Private Health Facilities Three major categories of private health facilities will be surveyed - big hospitals (large size), nursing homes/small hospitals/maternity homes (medium size) and clinics/single providers (small size). In addition, all private medical colleges (in all districts, not just the 171 sample districts) must be covered in the assigned states. The total number of private health facilities to be surveyed for each state is given in Annexure A. The list of private facilities to be surveyed in the above categories will be generated by IIPS after the listing exercise NGO/Trust Health Facilities (not for profit) IIPS will provide a list of health facilities which are run by NGOs/TRUST to be surveyed in addition to data from listing exercise in sampled districts and towns. Total numbers of NGOs to be surveyed in the six study states are given in Annexure A. The name and place of these NGOs to be surveyed, will be provided by IIPS after receiving data from listing exercise of NGOs/Trust hospitals from FA. 1.6 Data Collection Procedure for the HFS Data will be collected by trained professionals with medical/paramedical backgrounds. Accordingly, FAs shall recruit and train the required number of investigators with the qualifications listed in Table 2.1, to conduct the fieldwork. During data collection, each district will have 4 teams of interviewers and 2 supervisors (each supervisor will supervise 2 teams). Each team comprises two interviewers. Once data collection is completed in a set of five to six districts, these teams will move on to the next set of districts. A full team comprising of 2 interviewers must be sent to the CHC level and above in public facilities; and to 30 bed and above private facilities. For smaller health facilities like PHCs and private clinics managed by a single doctor without in-patient services, a single interviewer will conduct the interview. There will be a district coordinator who will be overall in charge of monitoring the progress of 2-3 districts in a state. FAs will ensure that the investigators take informed consent from the eligible individuals/respondents (as required) before conducting the survey in each facility. 12

12 2 SCOPE OF WORK The proposal should be prepared based on the following scope of the work. 2.1 Manpower requirement The Field Agency will be required to appoint the following manpower (core team: State Coordinator, IT Coordinator and Health/District Coordinator) in the above mentioned six states to conduct this study: Table 2.1: Educational Qualification and experience of required Manpower for the survey Serial No. Name of Position 1 State Coordinator 2 I.T. Coordinator (Full time) 3 Health/District Coordinator (Full time) No. Educational Qualification (Minimum) State Level Staff (Core Team) 1 per state PhD in Demography / Population Studies / Mathematics / Statistics / Public Health / Social Sciences/Health or Hospital Management 1 per state BE/B. Tech (Computer Science)/PG Diploma in allied subject 2 per state Graduate in Medicine/Masters degree in hospital/health management / Social Sciences/Population Studies/Health Sciences/Demography/ Health Field staff Experience At least 5 years of experience of handling (conducting and coordinating) demographic and health/facility surveys as a team leader At least 2 years of experience handling demographic and health survey data. Working experience of any current DBMS preferably CS Pro At least two years of experience in largescale health facility surveys and data collection processes Field Team Ratio Educational Qualification (Minimum) Experience 13

13 4 Research Investigator (RI) per district For Gujarat and Tamil Nadu the ratio of RIs to a district would be 1 :1 For the rest of the four states the ratio of RI to a district would be 2:1 Graduate in Health Science/ Bio Science /Medicine/ Paramedics Preference will be given to health and paramedics 5 Supervisor for Facility Survey One per team (a team consists of 2 RIs ) Graduate in Health Science/ Bio Science /Medicine/ Paramedics Having experience of at least one health facility survey in the past. Preference will be given to health degrees and paramedics 6 Lister per district 7 Supervisor for listing 4 Listers for every 5 districts One Supervisor for Four Listers Graduate in Health Science/ Bio Science /Medicine/ Paramedics Graduate in Health Science/ Bio Science /Medicine/Pa ramedics Preference will be given to those having experience of largescale surveys Having experience of at least one health facility listing exercise and supervising such exercise. Note: Team composition for Listing exercise: means four listers in a team that will be supervised by one supervisor. However, a lister can independently list facilities in the area assigned to him. Team composition for facility survey (RIs): means two RIs in each team supervised by one supervisor. 2.2 Attending TOT Workshops organized by IIPS IIPS will conduct three training workshops: Listing Exercise A one-day classroom orientation will be conducted for the head of the listing exercise appointed by each FA. This orientation will be held at IIPS, Mumbai and FAs needs to make 14

14 provision for the travel of their representative to attend the orientation. The timing of this training will be soon (within a week) after signing of the contract between the IIPS, Mumbai and the FAs Training of the Trainers (TOT) A TOT for two members of the core team (i.e. one state coordinator and one health/district coordinator) at a centralized location for all selected states for the main survey will be conducted. Therefore, each FA of the respective states will have to depute two members of the core team to attend the TOT. The core team has already been defined in the table given in Section 2.1. The duration of this TOT will be 7 days, which includes 3 days of field practice in both urban and rural areas IT training The IT coordinator of each FA from the respective state will be called for separate software training at IIPS, Mumbai within two weeks of the TOT. In case of any violation, IIPS, Mumbai reserves the right to terminate the contract or charge an appropriate penalty. Note: All the staff trained for the specified activity must be available till the completion of the survey. 2.3 Listing exercise As mentioned above the selected states are Uttar Pradesh, Madhya Pradesh, Bihar, Assam, Gujarat and Tamil Nadu. A total of 171 districts (status as per the Census 2011) will be selected from these six states (see Annexure A, for no. of districts). During the listing exercise, private health facilities meeting certain criteria and selected categories of public health facilities are to be listed for this study. FAs also should confirm the list and status of a few types of public/ngo health facilities before finalizing the complete list. Facilities of the following types should be listed as per protocols given below Public Health Facilities 1. Sub-Divisional Hospitals (SDHs):- FAs should reconfirm the list of sub-divisional hospitals provided by IIPS, Mumbai. If any additional SDHs exist according to district administration (CMO/DHO) reports, FAs must update the list. 2. Large Public Hospitals and large Municipal Hospitals:- FA also needs to list all the large publicly funded hospitals (state/centre/universities or those classified as Public Sector Units) other than district and sub-division hospitals, which have 30 beds or more offering 15

15 abortions or have PAC providers/services in all sampled urban areas. This would also include those hospitals, which are funded by the ministries/ departments other than the Ministry of Health and Family Welfare either of the state or central governments. Similarly, large municipality-run hospitals that offer OBS/GYN services and, in particular abortion or PAC services, must be listed in all sampled urban areas. 3. Urban Health Post/Urban Family Welfare Centres (UHPs/UFWCs):- FA should list all such centres where a lady medical officer (OBS/GYN) is on staff in the selected districts of the respective states. This list can be developed after discussion with district/municipal administration followed by physical verification of the status of at least one lady medical officer (OBS/GYN) being on staff and present at the facility. 4. Primary Health Centres (PHCs):- FA must list all the PHCs administered by each of the selected CHCs. The following information about these PHCs must be collected and sent to IIPS in Excel spreadsheet (see Annexure B1 for the Excel template). It must include: a) Name of PHC b) Whether PHC is within premises (within 100 mts. of CHC boundaries) c) Declared/possess 24X7 PHC Status (Yes/No) d) Road Distance (in Kms.) from CHC e) Name of the CHC which administer the PHC Note: Listing Exercise for public health facilities in all sampled districts or sampled urban areas of above categories 1 and 2 must be done within 21 days time in one go. An Excel worksheet (see Annexure B2 for the Excel template) must be submitted to IIPS 7 days prior to health facility survey beginning. Listing Exercise for public health facilities of above categories 3 and 4 is a continuous exercise, i.e., the list of these facilities for a group of 5-6 districts must be completed 15 days prior to start of the health facility survey in that group of 5-6 districts. The list must be sent to IIPS within 7 days of completion so that IIPS can send the final list of sampled health facilities in categories 3 and 4 to the FAs for conducting the HFS interviews Private Health Facilities 1. Rural Private Health Facilities: All private facilities in the catchment area of 50 percent of the selected CHCs will be listed. The list of the selected CHCs will be provided by IIPS. CHC staff, nearby medical stores, pharmaceutical suppliers and other similar key informants 16

16 will be useful to help in collecting the names and locations of rural private health facilities which provide abortion or PAC services. 2. Urban Private Health Facilities: All the private health facilities providing abortion and/or PAC services are to be listed in the selected towns with a total population between 5000 and 99,999 as per the 2011 Census. The list of the selected towns will be provided by IIPS. All the private health facilities providing abortion and PAC services in the 64 Urban Sample Units selected (USUs: Groups of contiguous census wards, each comprising around 100,000 population) in cities of size 100,000 and above are to be listed. IIPS will provide the list of wards from these cities to cover for listing these facilities. The data are to be collected and recorded on an Excel form (see Annexure B3 for the Excel template) FAs must collect the below mentioned information during the listing of private health facilities and send to IIPS as stipulated in the note below in the Excel sheet in the format provided by IIPS (see Annexure B3): Minor OT (Operation Theater) Equipped Labour Room where MTP/PAC services can be done Presence of health providers like: o An MBBS doctor who is providing reproductive health (RH) services o OBS/GYN o Number of beds (Maternity and total beds) o Type of facility (Hospital, nursing home, clinic, etc.) o Ownership of facility o Whether or not facility is registered/certified for MTP o Contact information (name of contact person, address, phone number, landmark, etc.) Note: Listing of private facilities is a continuous exercise, i.e., the list of private health facilities for a group of contiguous 5-6 districts must be completed 15 days prior to start of the health facility survey in the group of these 5-6 districts. The list must be sent to IIPS within 7 days of completion so that IIPS can send the final list of sampled private health facilities to the FAs for conducting the HFS interviews. 17

17 NGO/ Trust Health Facilities FA will be responsible to undertake listing exercise in the selected districts/ towns while undertaking listing for private health facilities. The data will be collected in the format provided by IIPS. This will be a parallel activity while conducting the listing of private health facilities in both urban and rural areas. Besides the listing exercise, the FAs need to collect the below mentioned secondary documents: FOGSI and/or IMA lists of OBS/GYNS From District Level Committee (DLC) or District headquarters list of all registered MTP providers (at state level). 2.4 Trainings of Field Staff to be conducted by FA 1. FAs will organize the first training/orientation programmes on facility listing. Only staff trained by IIPS shall be eligible for the training of the listers and their supervisors within five working days after the completion of Lister s orientation at IIPS. 2. FAs will also organize an 8-day training (including 3 days of field practice) for research investigators and supervisors at the headquarters of a district which has not been selected for the study. The core staff who attended the TOT organized by IIPS will be eligible to conduct the research investigators training. The FA must seek prior approval at least two weeks in advance for the training schedule, venue and agenda. Faculty Coordinators, an SPO and Project Officers from IIPS will also be present at the time of training. Representatives from the Guttmacher Institute will also be present during the training of the research investigators. FAs must ensure availability of all the audio-visual equipments, logistic arrangements, and arrange comfortable stays for FA investigators as well as for other FA staff members. IIPS reserves the right to stop the training or terminate the contract itself, if any protocol is violated by FA. The cost of any delay due to such actions will be borne by the FA. 3. Special lectures from experts in the related field and supporting materials (handouts of IIPS, PowerPoint presentation, approval letters, manuals and schedules) and other stationeries needed for the training, should be arranged by FA. Training sessions should be arranged in a place where classroom presentation, mock interview and feedback session can be held. 18

18 4. At the end of the training, FAs must conduct a test to evaluate the performance of the research investigators and supervisors. IIPS will provide the question paper for the evaluation. IIPS will allow FAs to recruit only those investigators who score above 75 percent in the test. 5. The field staff will then be given the opportunity to practice to conduct the interviews in the facilities not selected in the study to ensure that the translation of the interview schedule is completely understandable for our targeted respondents, e.g. all questions make sense when translated and respondents understand what the interview schedule is meant to capture. The practice interviews should be conducted with an appropriately diverse sample of health facility types and with an adequate number. Should any problems be found at that stage, the Field Agency must bring those to IIPS attention immediately and IIPS will advise how to proceed further in such cases. 2.5 Major contents of the Health Facility Survey (HFS) Schedule The information to be collected in HFS is as follows: Facility: Location-urban/rural, capacity, RH services provided Respondent Information: Person interviewed, his/her qualification, years of work at the facility Abortion services: Availability of abortion facilities, types of available services, reasons for non-availability, reasons for refusal of services to patients, referrals, average number abortion cases, number of staff trained in abortion care provision Post-abortion Complications (PAC) Care: Availability of PAC services, types of facilities available, referral place in case PAC services are not available, staff trained on PAC care, average number of PAC patients per month, mortality due to PAC, cost for PAC services at the facility Contraceptives choices offered to abortion and PAC patients: Available contraceptives services at the facility, supplies of contraceptives, management during low supply, place of referral in case of low supply or services not been available, percent of women availing contraceptives post-abortion, most preferred contraceptive among women undergoing abortion General: common reasons for abortion, barriers in accessing abortion and post-abortion complication care services, recommendations for steps to reduce unintended pregnancies and improving PAC care to women. 19

19 Note: A copy of the interview schedule is attached as Annexure C. 2.6 Transportation FAs will be responsible for arranging and for covering the cost for adequate transportation for their field staff during the entire fieldwork operation including listing and for the survey. 2.7 Salary and DA for Interviewers Research Investigators (RIs)/ interviewer at the field level are the most important person to maintain quality of data collected. The FA must pay at least the minimum salary to Listers, RIs and supervisor level staff. As per the IIPS protocol, a fixed minimum salary to the Listers and RIs shall be Rs. 16,000/- per month. In addition, a minimum DA of Rs. 250/- per day should be given to the Listers, RIs and other field staff. This salary/da shall exclude transport/conveyance allowance / reimbursement or any other service fee of outsourcing manpower agency. FA ensures that RIs/ Listers/ Supervisors will be given salary from the first day of the training itself. Team supervisors should be paid an additional amount either as part of their salary or DA. FAs must make provision and pay for group insurance to all the field staff deployed in this study. FAs should ensure timely payment to field staff as per the contract and a signed copy of the receipt and the bank statement for the same should be sent to IIPS on a monthly basis. Therefore, the FAs are advised to ensure that every staff member recruited for this study has a valid bank account. Any complaint reported by field investigators regarding irregularity/non-compliance of this clause in the payment of salary or DA will be taken seriously by IIPS, as it directly affects the data quality. FA must send bank statement to ensure the salary of each month has been transferred to employee s account. IIPS PO/ SPO/ Faculty Coordinators will ensure to announce these amulments at various stages of training and interaction with RIs/ Listers/ supervisors. Further, IIPS reserves the right to check whether the FA follows the above mentioned norms and to terminate the contract if any FA is not complying with these requirements. 2.8 Layers of Monitoring and Supervision FA has to put in place a three-tiered monitoring and supervision mechanism to maintain the data quality at all the stages of data collection (listing and main survey). The first level of monitoring will be done by the team supervisor of the RIs. At the second level, District/Health Coordinators will monitor the quality of work done by the team supervisors. Each District Coordinator will have the overall responsibility to monitor the field staff of 2-3 districts and they will liaise with and make the necessary appointments with appropriate 20

20 facilities and respondents, ahead of the actual administration of the survey. The last layer of supervision will be conducted at the FA level by the state coordinator (head of core staff) or the head of the FA on regular basis. Therefore, the state coordinator along with the signatory of the contract with IIPS, hold the ultimate responsibility for quality of data collected. 2.9 Listing and Survey The field agency should complete the listing of private health facilities in rural and urban areas and public health facilities (Municipal hospitals, urban health and family welfare centres/ urban health posts with OBS/GYN facility and inpatient department) and NGOs/trust hospitals, in the selected districts of assigned states and prepare a consolidated list in an Excel sheet according to the formats provided in the Annexure B1, B2 & B3 and send it to IIPS within 7 days of the completion the listing exercise. The listing exercise must be done well in advance, so that the result of the exercise of listing in a group of 5-6 selected contiguous districts should reach every time to IIPS in an Excel sheet 15 days prior to the beginning of the HFS interview in those 5-6 districts. The District Coordinators shall supervise all the listing teams in their respective districts. All the original copies (hard copies) of the listing forms shall be preserved carefully and submitted to IIPS in the end of the survey. Team composition for Listing exercise: means four listers in a team that will be supervised by one supervisor. However, a lister can independently list facilities in the area assigned to him. Team composition for facility survey (RIs): means two RIs in each team supervised by one supervisor State Level Field Office of Field Agency Field Agencies appointed for the respective state must have a regular functional office with appropriate seating space for all core team members of that state for which they are applying. The office must also be equipped with electricity, IT infrastructure, and means of communication (fax, landline telephone, internet, etc.). The office should also compulsorily have a safe storage space to ensure that the survey instruments are stored in good condition, in order to be able to return all interview schedules and original listing forms to IIPS in good condition as per the prescribed time-line of the contract and payment schedule. This office should be functional during the entire duration of the contract between IIPS and FA. 21

21 2.11 Data Collection for Health Facility Survey The total duration of data collection in one state will be 90 days including a weekly holiday. As mentioned before, the survey will cover public, private and trust/ngo hospitals that have the potential to provide abortion services and post abortion complication care. The categories of respondents may include the Director or head of facility, Obstetrician/Gynecologist, MBBS doctor specialists (e.g. surgeon), Public Health Nurse, Staff Nurse, Auxiliary Nurse Midwife (ANM) in PHCs, Chief of clinic/clinic in-charge, Medical officer, Medical officer (MCH), or AYUSH doctor. Some information may also be collected from medical records available in facilities if permission is granted. All the completed interview schedules will need to be field edited by the team supervisor and a random check of field edited interview schedules will be done by Health/District Coordinator on a regular basis. The transportation of completed interview schedules from the field to the state headquarters should be safe and strictly confidential, and there should be a proper maintenance of stock of delivery and dispatch of interview schedules Data Management and Entry The data entry process will start as soon as the first set of completed survey interview schedules from 5-6 districts reach the field agency state headquarters. The data entry will be done using software developed by IIPS in CSPro. FAs need to carry out double data entry in this study and a provision has been made in the software prepared to accommodate this, therefore the agency must make arrangements of suitable computers with the configuration given in Attachment D of specimen contract. Certain validation and error checking messages will be pre-loaded in the software. After IIPS conducts validation through checking the data, feedback will be given to concerned Field Agency. The FA must make necessary changes (rechecking the questionnaire, retraining the RIs, addressing specific interviewer or supervisor problems) based on the feedback to improve the data quality. The FA must take appropriate and suggested action on validation reports generated by IIPS. IIPS reserves the right to stop fieldwork or terminate the contract in case FAs do not take appropriate actions on the feedback Meaning of Complete Work : In this study, complete work means the completion of activities- training, listing, data collection, double-data entry, data validation, submission of final data and Return of filled-in interview schedules, listing material and formats, in time bound manner. In case, an FA fails to deliver any of the activities/deliverables due to which IIPS cannot generate state-level report, IIPS reserves the right to terminate the contract and 22

22 recover the whole cost of the study in the assigned state. IIPS will also impose the penalty and recover the prevailing interest on the amount paid to the agency till the date of recovery. 3 ROLES AND RESPONSIBILITIES OF FIELD AGENCIES (FAs) The Unintended Pregnancy and Abortion in India study will be conducted in six states: Uttar Pradesh, Madhya Pradesh, Bihar, Gujarat, Tamil Nadu and Assam. The selected FA for each state will be required to sign a contract with IIPS for implementing the Health Facilities Survey (HFS) in that state. A specimen copy of the contract is attached as Annexure J. 3.1 Overall Roles and Responsibilities Assigned to Field Agencies The principal responsibility of the FA is to carry out the HFS fieldwork in the assigned state. The sample will be spread over rural and urban areas of the assigned state. The successful bidder will have to sign Memorandum of Agreement (MoA) with IIPS before starting any work under this study Sub-contracting/ sub-letting/ consortium is not allowed at any stage of the study starting from applying for biding till the completion of the work assigned under the contract. IIPS reserves the right to terminate the contract and/or take appropriate legal action against the FA if any such incidence is noticed or reported at any point of time during the contract period FAs will submit a clear description of roles and responsibilities for each level of their staff recruited exclusively to HFS under this study in the bid document. IIPS may give input on roles and responsibilities which will then be incorporated in the final version of roles and responsibilities to carry out the HFS. FAs must provide a copy of resume, proof of identity (Aadhaar card/ driving license/ passport/ voter ID.) and minimum qualification of all the core staffs recruited along with the bid document. FAs must sign an agreement for a minimum duration of 11 months or till the completion of data entry and validation, whichever is earlier, on non-judicial stamp paper of Rs. 100/- with all the core team members (State Coordinator, IT Coordinator and Health/District Coordinator) whose names are mentioned in the bid document, clearly defining their roles and responsibilities. In case of those FAs which are deploying their permanent staff (regular payroll) need to attach a written consent along with their roles and responsibilities of the employee to work exclusively for this study for the aforesaid period. A contract is to be signed between the Director of IIPS and the head of selected Field Agency before starting any work related to 23

23 Unintended Pregnancy and Abortion in India study. The commencement of the work will take effect from the date of the signing of the contract with IIPS and continue till the contract period. These documents have to be submitted along with the technical bid. The members of the core team cannot be changed at any stage of the contract FAs must mention in the proposal for the specific states, the names of persons in the core team who will attend the TOT (listing and survey) conducted by IIPS. The core staff members will be responsible for conducting the training of the listers, supervisors and RIs for the state in the local language FA is responsible for carrying out three major types of work for the study. These areas are (1) listing of health facilities, (2) conducting fieldwork of the HFS, and (3) data entry (including double data entry, validation and editing, etc.) After FAs completion of the listing operation of private health facilities, NGO/ Trust Health facilities and selected public health facilities in both rural and urban areas, IIPS will prepare the final sample list and supply it to FAs. FAs shall adhere strictly to the sampled facilities provided there will be no facility replacement allowed. FAs will prepare Excel spreadsheets for all the listed facilities in the prescribed format provided by IIPS. Due arrangements should be made by the field agency to store the survey instruments (hard copy of listing materials, filled-in interview schedules and other material related to this study) in a secure manner. These materials must be returned in good shape to IIPS before FA receives the last installment of the contract amount FAs need to provide comprehensive two-day training to the listers for conducting the listing exercise FAs must finish listing of public facilities (Municipal hospitals, urban health centres/posts, Sub-divisional hospitals and other public establishments) where induced abortions/ PAC services are provided FA must complete the listing of private facilities 15 days in advance before starting HFS in a group of 5-6 selected contiguous districts. The above-mentioned Excel spreadsheet must be sent to IIPS 7 days prior to start interviewing the facilities, for selection of private facilities in these districts. This is a continuous exercise till the completion of all the districts to be surveyed. 24

24 Training of RIs and supervisors in each state will be for at least 8 days and each RI should complete at least four interviews in the field during the training. Supervisors must be given one-day additional orientation on how to supervise fieldwork following the supervisor manual. FA is responsible for arranging good quality fooding, lodging and sitting arrangements as well as audio-visual instruments for all the trainees. FA will start giving salary to Rs/ Listers/ Supervisors from the forst day of the training itself Field Agency will print a sufficient number of interview schedules for training, reference and fieldwork. The cover and last page of the interview schedule and manuals should be thick and properly stapled/stitched with the pages inside. In addition, FA needs to have sufficient copies of manuals- interviewer, supervisor, Lister and data entry FAs will plan all fieldwork activities including listing of private facilities and inform IIPS of the fieldwork schedule along with details of the team movement plan at least two weeks in advance of the beginning of the fieldwork. Field work should not be started before getting permission from IIPS. FAs must not change field work plan/team movement without the approval from the IIPS. All the field activities (listing and survey) should be carried out in contiguous districts FAs are required to ensure that each interview is done only after obtaining the informed consent of the respective respondent. FAs will also ensure that investigators keep all the information strictly confidential FAs should strictly adhere to the timeline of the survey failing which a penalty equivalent to 0.5 % of the total cost per week will be imposed IIPS will be providing instructions/suggestions from time to time to maintain the quality of data. These instructions must be strictly followed by FAs for the smooth conduct of the survey and maintaining the quality of survey A set of field-check tables as well as monitoring feedback will be sent to the FA regularly by IIPS. FAs are required to comply with the feedback and reorient the investigators if needed FAs are required to extend full cooperation to the monitoring personnel from IIPS/Guttmacher Institute appointed for this study. 25

25 FAs are strictly advised to refrain from extending any favours to any monitoring staff of IIPS or other monitoring staff. IIPS reserves the right to take appropriate action if any such incidents are brought to the notice of IIPS. FAs must cooperate with the IIPS monitoring and supervision team or personnel working on behalf of IIPS. Any direct or indirect interference that hinders the monitoring and supervision work can amount to termination of the contract along with a suitable penalty. IIPS may blacklist the agency if it is found to be involved in any such type of malpractices FAs will also be responsible for payment of internet charges for transferring data files from the state office to IIPS For facility survey, three visits on three different days, must be made to each facility before treating them as a refusal during data collection. FAs should send weekly progress reports every Friday, in a format prescribed by IIPS (format will be provided at the time of TOT), to report the field level plan and progress FAs must develop and implement a three-tier monitoring and supervision system as stated in Clause 2.8 to ensure high quality of data. District coordinators and supervisors must be available for monitoring and action taken and supportive supervision, in the field throughout the fieldwork period of the study including listing exercise. State coordinators of FA must make regular visits to the field Arrangements should be made by FAs for additional manpower and logistics for safe transfer of survey tools, private facility listing files and other logistics from the field agency state HQ to the IIPS FAs will be responsible for field editing, office editing, double data entry and data validation and action taken on the feedbacks provided on data before the final submission of data to IIPS as per the protocols decided by IIPS FA needs to submit field survey tools, related documents and listing materials to IIPS at the end of the study. The cost related to transporting survey tools and related documents from FAs to IIPS after completion of the survey will be borne by FAs To get proper response from the private health facilities, FAs must publicize the survey through appropriate forums (FOGSI/other associations) and other appropriate means 26