TERMS OF REFERENCE CONSULTANCY TO CONDUCT A TRAINING NEEDS ASSESSMENT ON HEALTHCARE WASTE MANAGMENT IN SELECTED HEALTH FACILITIES.

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1 TERMS OF REFERENCE CONSULTANCY TO CONDUCT A TRAINING NEEDS ASSESSMENT ON HEALTHCARE WASTE MANAGMENT IN SELECTED HEALTH FACILITIES. 1. Background Kenya has received a grant from the Global Environment Facility (GEF) towards mainstreaming sound chemicals management and reduction of untintentionally produced persistent organic pollutants from open burning of waste and thermal disposal of health care waste. This five year, , project is impelemented by the Ministry of Environment and Natural Resources (MENR) in partnership with national and county goverment agencies, civil society and private sector. The project intends to protect human health and the environment by managing the risks posed by production, use, import and export of chemicals and reducing /preventing the release of U-POPs and toxic compounds originating from the unsafe management of waste in two key sectors: Health Care Waste and Municipal Waste. These sectors are among the highest priorities identified in the reviewed and updated National Implementation Plan. The linkages between sound chemicals management, waste management in general and health care waste in particular, and how open burning of waste leads to emissions of unintentionally produced persistent organic pollutants (UPOPs) is outlined in the project document (Prodoc). The consultant is encouraged to read the project document (Prodoc) to acquint themselves with the targeted project interventions. The Prodoc is available at and additional information is available in the convention site This specific consultancy relates to the prodoc as follows: Although a substantial amount of regulation on HCWM is in force in the country, the level of enforcement is very low. It has been very often observed, in course of the site visits, that HCW is dumped or open burnt near the hospitals. Most of the incinerators operate out of control without fulfilling the minimal requirements for occupational and environmental safety. The regulations need to be updated to become compliant with the WHO guideline on HCW and with the technical and environmental standards suggested by the SC BAT for the disposal of hazardous waste. No Hazardous Waste Manifest System for keeping track of waste production, transportation and disposal is in place. 1

2 Many incinerators in operation are of very basic design, badly maintained and/or inadequately operated, and as such are very far from the recommended value of 0.1 ngteq/m 3 under the BAT guidances of the Stockholm and Basel Conventions. There is very low awareness in the country concerning the BAT and BEP for HCWM disposal. There is a lack of national-level or county-level planning on the management of HCWM, therefore most of the hospitals operate in the logic to dispose their own waste. Because of financial constraints and insufficient budget allocation for HCWM, many HCFs lack the necessary equipment/supplies/infrastructure to be able to practice good segregation, adhere to best environmental practices for HCWM and safeguard staff, patients and surrounding communities. This includes color-coded bags, waste bins, Personal Protection Gear (PPG) for those handling the waste; waste carts for transportation; (intermediate) storage facilities; designated HCW transportation vehicles; and (functioning) HCW treatment facilities adhering to BAT requirement (including fuel to operate them and budgets for spare parts and maintenance). As the monitoring capacity for U-POPs is lacking, no measurement of the emissions of PCDD/F from the existing incinerators / burning chambers have been attempted: this contributes to the lack of awareness of the hazards posed by the improper management of HCW. The most obvious reasons for identified shortcomings appear to result from insufficient training and awareness of staff in combination with limited financial and human resources allocated to HCWM at national, county and HCF levels. Outcome 1: Personnel of hospital facilities and control authorities at national and county levels have enough capacity guidance and equipment to manage healthcare waste in an environmentally sound manner. Outcome 2: Implementation of best available technologies and best environmental practices (BAT/BET) at selected health facilities successfully demonstrated and measured against baselines. 2. Objective of assignment The objectives of the consultancy are; 1. To identify health care waste management capacity building gaps among healthcare workers in the selected health facilities. 2. To identify the skills and knowledge required for effective healthcare waste management generall and at selected health care facilities identified in the project document. 3. To identify the gap between the skills and knowledge available and required for sound chemicals management, open burning of waste general and health care waste. 4. To develop an institutional and individual capacity building plan for Kenya 5. To map out and list the methodologies, institutions, resource agencies, materials, etc for capacity building and knowledge linking available locally, regionally or globally 6. To quantify amount of health care waste in terms of tons/kilogrammes which can be managed in an environmentall sound manner. 2

3 3. Scope of Work The scope of this consultancy covers capacity needs assessment and training for health workers in the 13 targeted health facilities with more specific focus to facility health management teams, health workers in the health care facilities and related clinical areas, waste handlers and incinerator operators in the targeted health facilities. The consultant will be required to undertake the following: i. Submit an Inception report detailing the understanding/ interpretation of the TORs; the methodology of carrying out the assignment; work plan and implementation schedule as agreed upon with UNDP,MENR and MOH ii. Assess the capabilities ideally required and the existing gaps at different levels especially in relation to a comparision of the facilities to avoid open burning, low technology incineration and introduction of effective non burn technologies. iii. Visit the selected health care facilities and do onsite reports and consulation with the health care management at the facility, county and at MOH iv. Suggest a capacity building plan, methodologies, materials and resources for different categories of health workers mentioned above. v. Conduct specific field visits to the targeted facilities for undertaking training needs assessment vi. Present the report in a stakeholders workshop 4. Deliverables The following are key deliverables for the assignment Report detailing the understanding/ interpretation of the TORs; the methodology of carrying out the assignment; work plan and implementation schedule as agreed upon with UNDP,MENR and MOH submitted 3 days after signing of contract. Final agreed upon inception report by week 1 A repport of the training needs findings at the health care facilities Presentation of the findings to stakeholder validation meeting 25 days after signing the contract. Training needs assessment report to be shared in a stakeholder workshop Final Training needs assessment report (1 hard and soft copies) to be submitted to both UNDP thropuh MOH and MENR 5. Reporting Modalities The Consultant will work under the overall guidance of the Team Leader, Energy, Environment and Climate Change, UNDP Country Office, Kenya with day to day supervision by the UNDP EECCU Programme Analyst in close collaboration with the MOH, World Health Organization, Kenya Country Office, with day to day supervision by the Project implementation Unit in the Ministry of Environment and Natural Resources. 6. Duration of Consultancy The assignment is expected to take 32 working days. The assignment is expected to be carried out between May to June

4 UNDP will cater for the travel costs out of Nairobi where such trips are deemed necessary after consultations, as well as convene and support one stakeholder meeting for feedback on the consultancy findings. 7. Program of Work The consultant shall split time to cover the work schedules as follows: Activity Timeframe (Days) Preparation / Inception report 2 Field Visits 20 Data entry/analysis 5 Draft report 2 Stakeholders Validation meeting 1 Revised and finalized report 2 Total Qualification and Education Experience Required professional Skills and Experience Education Advanced University degree in, Environmental Health/ Public Health, environmental protection and management, chemical and industrial engineering, and other relevant fields. Masters degree in any of these fields will be an added advantage. Experience At least 5 years experience in healthcare waste management, municipal and hazardous waste management Knowledge of and experience with implementation of the multilateral environmental agreements such as the Stockholm, Basel, Minamata and other related conventions and agreements is an asset; A good understanding of WHO manadates in the MEAS and in SAICM Experience in international project implementation is an asset; 9. Competencies High level written and oral communications skill in English. Must be a results-oriented team player with excellent interpersonal skills, including enthusiasm, tact, diplomacy and high integrity; Concise and analytical thinking; Professional in working with government counterparts, team player; and, Must be able to communicate effectively in English language (verbally and in writing) in a cross-cultural environment. Ability to work with minimal supervision 4

5 10. Evaluation Criteria Only candidates obtaining a minimum of 70 points will be considered Criteria Weight Max. Point Technical 100% 100 Academic qualifications, experience and relavance Experience in health care management at national 25% 25 and international levels Knowledge of and experience of MEAS and Health 25% 25 Sector Strategy of WHO Analytical and report writing skills 20% 20 Experience in result-based management 10% Remuneration The successful consultant will be paid on UNDP terms and condition for the relevant contract modality; and Payment will be done against a disbursement schedule as outlined in the contract and based on receipt of clearly defined deliverables with a specific timeline. Transport for field work will be provided by the project. DSA will be provided to the consultant while in the field EVALUATION Method: cumulative analysis method will be used to evaluate proposals. The evaluation Criteria as shown below shall be used to evaluate all the proposals received. The award of the Individual Contractors Contract shall be made to the individual contractors whose offer has been evaluated and determined as: Responsive/compliant/acceptable, and Having received the highest score out of a pre-determined set of weighted technical and financial criteria specific to the solicitation. Technical Criteria weight - 70 points Financial Criteria weight - 30 points The following formula will be used to evaluate financial proposal: p = y (µ/z), p = points for the financial proposal being evaluated; y = maximum number of points for the financial proposal; µ = price of the lowest priced proposal; z = price of the proposal being evaluated; Financial Proposal (30%): Your financial proposal shall include a breakdown of the lump sum indicating fees and any other expenses that consultant might think is required for the assignment. 5

6 Incomplete application and applications received after the deadline will not be considered. Only selected candidates will be notified. 12. Application process Interested and qualified candidates should submit their applications which should include the following: 1. UNDP Personal History Form (P11) - Template provided 2. Detailed Curriculum Vitae 3. Technical and financial Proposal and for implementing the assignment - Template provided Qualified candidates are requested to their applications to consultants.ken@undp.org to reach us not later than 5.00 P.M on Tuesday, 02 May Please quote Needs Assessment on healthcare waste in health facilities on the subject line. ANNEXES ANNEX 1 PROCUREMENT NOTICE ANNEX 2 - TERMS OF REFERENCES (TOR) ANNEX 3 - IC PROPOSAL FORM ANNEX 4 - P11 TEMPLATE ANNEX 5 - INDIVIDUAL CONSULTANT GENERAL TERMS AND CONDITIONS 6

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