TERMS OF REFERENCE
Cost analysis for improvement of different categories of Union Health and Family Welfare Centres of Bangladesh
One of the priority interventions in the current and next HNP sector program is to increase the coverage of skilled birth attendants. Strengthening the primary level facilities, especially the union level facilities for the provision of 24/7 delivery care services is widely recognized as a priority initiative to support this objective.
Aligned with the HPNSDP strategy and priorities, DGFP embraces an activity to strengthen the UH&FWCs to ensure availability and use of 27 basic obstetric care services, such as safe delivery, antenatal and postnatal care referral for complications to higher level facilities. In order to accelerate implementation of this strategy, the MOH&FW has taken this up as a fast track initiative and thus achieve the goals of the health sector program.
MaMoni Health Systems Strengthening (MaMoni HSS) is funded by USAID as part of the USAID’s continued commitment to contribute to the development of Bangladesh. Building on the successful work of the MaMoni project in Habiganj district, MaMoni HSS is designed with the goal to improve utilization of integrated maternal, newborn, and child health, family planning, and nutrition (MNCH/FP/N) services in Bangladesh. The project’s objective is well aligned with the Government of Bangladesh’s HPNSDP 2011-2016 and also next sector programme. The project supports the MOH&FW to introduce and leverage scaling up of evidence-based practices already acknowledged in Bangladesh.
During 2015-16, MaMoni HSS supported DGFP to conduct a nation-wide assessment of all union level facilities to determine their readiness to provide normal delivery care and newborn care services. This assessment also prepared a database of all facilities, number 4,161 in 64 districts of the country. This includes different types of facilities, such as Union Health and Family Welfare Centers (UH&FWCs), Union Subcenters (USC) and Rural Dispensaries (RDs), and are managed either by the Directorate General of Health Services (DGHS) or by the Directorate General of Family Planning (DGFP). The assessment also collected information such as condition of the facility, residence, instruments, availability of FWVs, their training status etc. The presence of more than 4161 union level facilities, which have been grouped into three categories based on their current level of readiness, present a unique opportunity to rapidly increase skilled attendance at birth. These facilities, if made fully functional in phase in process, collectively can accommodate to the health care needs of most unions, especially for life-saving maternal and newborn care services
All UH&FWCs, both under the management of DGHS and DGFP, are designed to contain at least two staff quarters, which means that at least the Family Welfare Visitors (FWVs) are available beyond routine service hours (8am-2:30pm). The current human resource situation is also conducive for scaling up facility delivery services. Most of the FWVs are already trained on midwifery, and could start providing service after a shorter competency based training/attachment.
The overall objective of the consultancy is to do an analysis of the costs and benefits of strengthening the union level facilities across the country to provide a minimum package of maternal and newborn care services.
The specific objectives are:
- To estimate the financial costs of providing essential maternal and newborn health services, including normal delivery care on round-the-clock basis, at union level facilities
- To estimate the incremental costs for strengthening the existing union level facilities to make them fully ready to provide essential maternal and newborn care services, including normal delivery care on round-the-clock basis
- To analyze the estimated benefits of strengthening the union level facilities in terms of increase in coverage of key interventions, reductions in morbidity and mortality (and possible, DALYs saved)
The main areas of costs for strengthening the facilities are:
- Infrastructure including electricity and water supply: walls, roofs, floor, windows and door, dumping pit, painting, toilets, running water
- Staffing, including clinical and support staff, proportionate to the level of utilization of the facilities
- Selected trainings of service providers: midwifery, HBB/ CNCP, QOC/IP
- Equipment required for safe delivery and minimum no of furniture: Delivery kit, tool, post-operative bed, bed side table, furniture
- Essential supplies, including drugs and consumables according to the level of utilization of the facilities (have to discuss about the process of getting this information).
3. Scope of work:
The person will do the costing and cost benefit analysis through
- Reviewing the available information in UHFWC assessment, the person will support organize the data to consider important renovations and refurbishments according to different category of UHFWCs available in all the divisions of Bangladesh
- S/he will look at essential infrastructure requirements followed by the instrument, furniture requirements for each category of the health centre
- S/he will look at relevant training requirement and analyse the costing of the training
The person needs to look at existing resources available with revenue budget, development budget and also allocation with local government to meet the resource requirement.
Collect costing information for Health Engineering Department (HED) and compare with costing from other sources.
MaMoni HSS and DGFP will collect and provide available data on service utilization and coverage using routine MIS reports.
- Summary report on UHFWC category wise (A, B, C) cost analysis.
- Separate chapters on category wise costing of a) infrastructure, b) residence, c) furniture for delivery room, d) essential equipment for delivery e) required trainings
The total duration of the assignment is estimated to be 20 working days, spread over a period of one month – from February 01, 2017- February 28, 2017.
6. Qualification and experience:
Academic qualification: Master’s degree in Health Economics or Economic analysis or other relevant discipline
Additional professional certificates: Professional certifications would be preferred.
Minimum 10 years’ experience in working with government health system. Should have adequate knowledge on infrastructure on Health Systems of Bangladesh. Must have good networking with key people in health arena in Bangladesh.
Strong track record of conducting costing studies and cost-benefit analyses for interventions in the health sector
Excellent Cost Analytical abilities
VAT Registration: VAT registration is mandatory for consultant to obtain consultancy service under USAID funded project.
Interested national individual consultant, may submit their technical and financial proposal along with CV and copy of VAT registration certificate to the following email address: email@example.com, application closing date: January 14, 2017.