REQUEST FOR PROPOSALS REQUEST FOR PROPOSALS (RFP) FOR THE PROVISION OF CONSULTANCY SERVICES TO SUPPORT IMPROVEMENT OF MATERNAL AND NEW BORN CARE IN THE 16 RHITES SW DISTRICTS In support of ELIZABETH GLASER PEDIATRIC AIDS FOUNDATION (EGPAF) (P.O Box 21127, Kampala) Firm Deadline: 16 April, 2018, 5:00 PM Eastern Time The Elizabeth Glaser Pediatric AIDS Foundation, a non-profit organization, is the world leader in the fight to eliminate pediatric AIDS. Our mission is to prevent pediatric HIV infection and to eliminate pediatric AIDS through research, advocacy, and prevention and treatment programs. For more information, please visit http://www.pedaids.org. 1. BACKGROUND Increasing utilization of quality maternal neonatal, child health services is one of the focus areas of the 5 year USAID/Regional Health Integration to Enhance Services (RHITES) in South West Uganda. The project is providing technical support to 16 districts with the following objectives: increasing utilization of health services, strengthening systems, improving quality of services, increasing availability of, access to and demand for quality services, and supporting the health sector to sustain higher service utilization rates. The just concluded national demographic health service revealed although Uganda has made significant strides in reducing maternal and infant mortality, newborn mortality has remained stagnant at 27/1000 live births (UDHS 2016). The health of the new born is influenced by a number of key factors starting from the preconception period through pregnancy to the quality of care and monitoring at the time of delivery. According to DHIS 2 data from October 2016 to June 2017, the newborn health situation in the southwest was as follows; newborn deaths within 7 days of birth averages 0.6% with 5 districts above the regional average; Bushenyi (1.6%), lbanda (1.4%), Kanungu (0.9%), Sheema 0.9% and Rubirizi (0.7%). 1.8% of the live births with in the health facilities had birth asphyxia. The districts above the regional average were lbanda (3.5%), Kanungu (3.4%), Bushenyi (2.9%0, Sheema (2.6%) and Rukungiri (2.0%). The proportion of macerated still births was 0.9% of the total deliveries were while 0.6% of the newborn outcomes were fresh still births with the highest in Kiruhura( 1.3%),Kisoro (1.3%),Mbarara (1.3%),1banda (1.1%),1singiro (1%),Rubirizi (0.9%),Kanungu (0.8%) and Kabale (0.8%). On average 97.5% of the babies born alive at the health facilities in the region received PNC at 6 hours although there is need to ensure that all babies born receive all the elements of essential newborn care package. Districts below the regional average include Mbarara (79.9%), Buhweju (89%) and Kanungu (93.9%). Preterm 1
births in the region average 1.6% with the highest number born in Ibanda (2.8%), Sheema 2.2%, Kanungu (2%), Rukungiri (1.9%), Mbarara (1.7%) and Kabale (1.7%). Average breast feeding within the first one hour is at 93.9%, lowest in Buhweju (76.7%), Rukungiri (89.4%), Kisoro (90%) and lsingiro (93.1%). Other gaps and challenges identified during onsite mentorship support include; poor infection prevention practices including lack of chlorhexidine for cord care, limited attention to keeping babies warm and inadequate providers' knowledge and skills in neonatal resuscitation, use of corticosteroids for preterm births and care of the sick and preterm newborns'. Gaps exist in emergency preparedness with emergency trays not fully constituted at most facilities while some lack designated areas for newborn resuscitation in labor suite. It is against this background that the USAID RHITES SW team is proposing to engage the regional capacity in MRRH and MUST to improve support and quality and newborn outcomes in the region. 2. OBJECTIVES: o To establish and strengthen regional capacity to provide ongoing support to improve maternal and newborn outcomes in the region o To build capacity of midwives and facility teams in key competencies to improve quality of care at the time of delivery and consequently newborn outcomes o To support the functionalization of neonatal care units and provision of quality maternal and newborn health services at target facilities. 3. PROPOSED AREAS OF ENGAGEMENT/SCOPE OF WORK: A) Capacity building: Training of health workers: The didactic training will be divided into two core competencies those related to the newborn as well as prevention and management of maternal health conditions that impact both maternal and newborn outcomes. The trainings will be preceded by a TOT training targeting 24 care providers to support the cascade trainings. Time frame: The 10 days TOT will be conducted in Q3 FY2018 The TOT will be followed by training of midwives at the facilities (two at HCIIIs, three at HCIVs and four from the hospitals).in year 3, the trainees will be selected from a total of 150 priority high volume sites with poor maternal and newborn health outcomes. Facilities targeted will be divided into two categories; Category 1: The training will commence with the previously trained 27 BeMONC facilities where health workers who have already been trained in BeMONC will receive additional training to strengthen the newborn components. Key competencies of focus will include newborn resuscitation, essential newborn care and care of the sick newborn including preterm. The training will also emphasize infection prevention and emergency preparedness in the delivery units. Time frame: These will be five day trainings, expected to be completed by the end of Q3 FY2018. Category 2: The training will be cascaded to an additional 123 facilities with poor newborn 2
outcomes. The training package provided to health workers at these additional 123 facilities will include both the maternal and newborn training packages. The maternal health package will focus on the leading causes of mortality which also ultimately contribute to poor newborn outcomes including: Management and prevention of sepsis, Preeclampsia and Postpartum hemorrhage using the helping mothers survive material. Emphasis will also be placed on emergency preparedness, infection control and monitoring during labour. Time frame: The 10 day trainings are expected to commence in Q3 FY 2018 and should be completed by the end of Q4 FY 2018. Onsite Placements at simulation centre at MRRH The didactic training will be followed by mentorship placements for the trained health workers at the simulation centre at MRRH to improve practical skills in both maternal and newborn competencies. Only one trained health worker from each facility will take part in the placements at a time to avoid negative effect on service delivery. Time Frame: Activity to continue through Q3-Q4 FY 2018. Monthly onsite mentorships Ongoing monthly onsite mentorship support targeting the 150 facilities will be provided by the trained TOTs in the districts. Mentorship support will include practical, simulation based approaches and will aim to address site specific gaps and challenges as well as obstacles to quality service delivery. Quality improvement approaches will be incorporated into the support. Initial mentorship visits will include a baseline assessment of the functionality of the BeMONC/CeMONC facilities and the quality of maternal and newborn care services so as to document facility specific gaps to be addressed during the mentorships. Time frame: Monthly activity through FY2018, 1-2 days per site each month. B) Support Functionalization of Neonatal care units according to level of care. Assessment of functionality of neonatal health services The team will support functionalization of neonatal care units at hospitals, HCIVs and HCIIIs according to level of care. Baseline assessments conducted at the target facilities will provide documented information about the gaps that would need to be filled to functionalize the newborn care units, kangaroo mother care corners, resuscitation corners and emergency trays at the facilities. Time Frame: Through Q3 and Q4 FY 2018 Targeted capacity building efforts to support establishment of NICUs Health workers placements at functional NICUs: Organize, support and facilitate placements for selected trained health workers at functional neonatal care units in the region such as MRRH and Kisiizi hospital. These health workers will be carefully selected and should be willing to work in the neonatal care units. At least three health workers from 25 selected Hospitals and HCIVs in the region will take part in the placements. Time frame: To be completed by end of Q3 FY 2018 Ongoing mentorship support: Provide ongoing support during the onsite mentorships to ensure functionality of the neonatal care units including practical technical practice support, staff schedules and documentation of newborn morbidity and mortality causes at each facility including introduction of newborn registers and mapping of origin at community level to facilitate targeted community support. All HCIVs and HCIIIs will be supported to functionalize KMC corners and newborn resuscitation areas. Time frame: To be conducted monthly 3
though FY2018. C) Pilot innovative approaches to improve newborn outcomes at 25 selected facilities high volume facilities ( The Air Device and PRISM) The use of the air device to improve the quality of newborn resuscitation will be supported at 25 selected priority high volume facilities with poorest outcomes. At these facilities the PRISM application device that enables care providers to access consultation about neonatal conditions will also be piloted. Results will inform possible scale up of these innovations to other facilities. Time frame: Activity to support through FY2018 and impact and or results documented by the end of FY. Resources to be provided by USAID RHITES SW 1) Facilitation for trainers during trainings and mentorships including per-diem (161000) and trainers fee (81000) per day and transport costs. However these rates are subject to an agreed upon position and rates with the SIM4life team. 2) Facilitation for health workers to participate in the trainings and offsite mentorship placements ( perdiem, transport and training materials costs) 3) Payment of training costs per heath worker at the simulation centre and during mentorship placements 4) Procurement of training mannequins including maama Natalies and neonatalies to be used by the TOTs and facilitators 5) Payment of venues and related costs during trainings 6) All procurements including equipment and supplies required to functionalize the neonatal units, with guidance and input from the consultancy team Resources to be provided by the MRRH/MUST team 1) Technical resource persons 2) Facilities at the simulation Centre 3) Technical resource reference materials to be reproduced and or procured by USAID RHITES SW Expected deliverables of the consultancy Activity reports within 5 days of completion of all capacity building activities (trainings, attachments, mentorships etc.) Weekly updates on ongoing activities and daily updates on capacity building activities Provision of all necessary technical training materials (USAID RHITES SW to do the printing and duplication) An overall activity report at the end of FY2018 detailing activities conducted, lessons learnt, recommendations and impact of the activities on outcome performance. Qualifications of the consultancy team: Medical doctors with a master s degree in Obstetrics and Gynecology or Pediatrics. Trained TOT for Basic emergency obstetric and newborn care Qualified trainer for simulation based training Experience handling similar consultancies and work as an added advantage. Proposed Timelines: Quarter 3 & 4: 75 Health facilities, on average 2HWS per 4
facility April 30 th to 4 th May 2018 TOT training May 7 th to 11 th 2018 Training refresher for regional senior TOTs May 14 th to 18 th Training category 1( First group) Training category 1( Second group) Simulation placements for regional TOTs May 29th to 2 nd June May 21 st to 25 th Placements simulation centre category 1 ( First group Placements simulation centre category 1 ( first group) June 11 th to June 15 th Placements simulation centre category 1( second group) Training category 2 ( first group) June 18 th to June 22 nd June 25 th to 29 th July 2 nd to 6 th Training category 2 ( second group) Placements simulation centre category 2 (first group) Training category 2 ( Third group) Placements simulation centre category 2 (Second group) Training category 2 (Fourth group) Placements simulation centre category 2 (third group) PHASE 11 : Scale up to additional 75 HFS ( category 3) in Q4 July 9 th to 13 Training category 3( first group) Simulation placements category 1-3 Monthly onsite mentorship support category 1 July 16 th to 20 th July 23 rd to 27 th July 30 th to 3 rd August August 6 th to 10 th August 13 th to 17 th August 20 th to 24 th August 27 th to 31 st Training (category 3) second group Placements simulation centre category 3, first group Training (category 3) third group Placements simulation centre category 3, first group Training (category 3) fourth group Placements simulation centre category 3, second group Monthly Onsite mentorship Category 1& 2 Training (category 3) fifth group Placements simulation centre category 3, second group Placements simulation centre category 3, third group Placements simulation centre category 3, third group Monthly Onsite mentorship Category1,2 and 3 Placements simulation centre category 3, fourth group Monthly Onsite mentorship Category1,2 and 3 5
Sept 3 rd to 7 th Sept 10 th to 14 th Sept 17t to 21 st Placements simulation centre category 3, fourth group Monthly Onsite mentorship Category1,2, 3 and 4 Placements simulation centre category 3, fifth group Monthly Onsite mentorship Category1,2, 3 and 4 Placements simulation centre category 3, fifth group Monthly Onsite mentorship Category1,2, 3 and 4 Sept 24 th to 28 th Progress review meeting and planning year 4 Note: The goal is to reach 150 health facilities by the end of year 3. Additional 83 health facilities and additional health workers from the original 152 HFs to be reached in year 4.Onsite mentorship activities to continue thought year 4 & 5 On average 2-3 health workers will be trained from each of the 150 HF Each training has 25-30 health workers MRRH to advise on numbers at simulation lab at a time ( approximated to be 10 health workers taking part in the one week placement at a time) Placements for selected health workers (from selected 25 units) at neonatal units to occur concurrently. Same facilities targeted for pilot with PRISMS. EGPAF now invites eligible Consultants to submit competitive proposals for the above consultancy. 4. EVALUATION CRITERIA AND SUBMISSION REQUIREMENTS: All proposals will be evaluated against the criteria below. Each proposal must contain the items listed in the submission requirements column in the order that they appear below. EGPAF will select the contractor that provides the Best Value to the Foundation. Evaluation Criteria Submission Requirements Weight Past performance of similar work Proposed Methodology Approach Price and Qualifications of proposed individuals, management to be working on the Consultancy Professional references (maximum 1 page each) from similar past consultancies with phone and email contact information and one or more examples of prior similar work Detailed proposal; maximum 5-page written proposal explaining the methodology, work plan and approach A clear cost breakdown for the consultancy as well as the total cost. Resume of proposed individuals to work on this project including references per individual. Medical doctor(s) with a master s degree in Obstetrics and Gynecology or Pediatrics is the preferred qualification. Trained TOT for Basic emergency obstetric and newborn care Qualified trainer for simulation based training Total 100% Failure to provide any of the above specifications and requirements may be 25% 35% 20% 20% 6
considered non-responsive and disqualify the applicant from final selection. 5. KEY CONTRACT TERMS The Foundation may exercise Option Years up to two years but subject to Consultant performance and availability of funding from donors. 6. SUBMISSION OF APPLICATIONS AND PROPOSED TIMELINE Interested suppliers can submit their typed quotations on the company s letterhead using the email below. DATE 27 March, 2018 ACTIVITY Release of RFP During working hours on the emails Submission of Inquiries directed to: procurementuganda@pedaids.org Any form of canvassing will lead to automatic disqualification of the firm 16 April, 2018 at 5:00 PM Eastern Time Completed proposals must be delivered electronically by the deadline mentioned on page one to: procurementuganda@pedaids.org NOT EXCEEDING 2MB 30 April 2018 Final decision announced and Offerors notified Please note it is our best intent to comply with the above timeline but unavoidable delays may occur. 7. ADDITIONAL INFORMATION All proposals and communications must be identified by the unique RFP# reflected on the first page of this document. Failure to comply with this requirement may result in non-consideration of your proposal. Any proposal not addressing each of the foregoing items could be considered nonresponsive. Any exceptions to the requirements or terms of the RFP must be noted in the proposal. The Foundation reserves the right to consider any exceptions to the RFP to be non-responsive. Late proposals/quotations may be rejected without being considered. The Foundation shall not be obligated for the payment of any sums whatsoever to any recipient of this RFQ until and unless a written contract between the parties is executed. 7
Equal Opportunity Notice. The Elizabeth Glaser Pediatric AIDS Foundation is an Equal Employment Opportunity employer and represents that all qualified bidders will receive consideration without regard to race, color, religion, sex, or national origin. 8.ETHICAL BEHAVIOR As a core value to help achieve our mission, the Foundation embraces a culture of honesty, integrity, and ethical business practices and expects its business partners to do the same. Specifically, our procurement processes are fair and open and allow all vendors/consultants equal opportunity to win our business. We will not tolerate fraud or corruption, including forging program outputs, kickbacks, bribes, undisclosed familial or close personal relationships between vendors and Foundation employees, or other unethical practices. If you experience or suspect unethical behavior by a Foundation employee, please contact our Fraud Investigations team at fraud@pedaids.org or the Foundation s Ethics Hotline at www.reportlineweb.com/pedaids/. Any vendor/consultant who attempts to engage, or engages, in corrupt practices with the Foundation will have their proposal disqualified and will not be solicited for future work. 8