Since its founding in 1971, MSH has worked in over 150 countries with policy makers, health professionals, and health care consumers to improve the quality, availability and affordability of health services. Working with governments, donors, non-governmental organizations, the private sector, and health agencies, MSH responds to priority health problems such as HIV & AIDS; tuberculosis; malaria; maternal, newborn and child health; family planning and reproductive health; and chronic non-communicable diseases such as cancer, diabetes, and lung and heart disease. Through strengthening capacity, investing in health systems innovation, building the evidence base, and advocating for sound public health policy, MSH is committed to making a lasting difference in global health.
PMI-S is a five-year, USAID-funded malaria project in Nigeria implemented by Management Sciences for Health (MSH) with the coverage of eight states: Akwa Ibom, Benue, Cross River, Ebonyi, Nasarawa, Oyo, Plateau, and Zamfara. The goal of the project is to contribute to the National Malaria Elimination Program (NMEP) vision of achieving “a malaria free Nigeria” and the PMI Strategy 2015-2020 goal to further reduce malaria deaths and substantially decrease malaria morbidity toward the long-term goal of elimination.
This goal will be achieved through interventions aimed at enhancing both the supply of and demand for malaria-related services within a stronger health system. Successful implementation of the proposed interventions is expected to result in improved coverage of quality malaria services, a strengthened health system for delivering higher quality malaria services; improved demand for, and use of malaria case management services; and improvements in the drug-based malaria prevention.
Objectives of the Consultancy
- MSH is seeking an experienced and highly skilled consultant with vast experience in the latest PMI malaria programming and research to conduct baseline analysis in four PMI-S intervention states (Akwa Ibom, Cross Rivers, Ebonyi and Oyo).
- The overall objective of the consultancy is to lead the design, implementation, analysis and reporting of the baseline.
The goals of the baseline analysis are:
- To assess the strengths and gaps of malaria programming and malaria service delivery in each state.
- To identify areas for strategic interventions to achieve project objectives and results using approaches tailored to state-specific findings.
- MSH invites you to submit an offer in accordance with the requirements of the following Solicitation. MSH must receive proposals no later than the Date and Time indicated in the table below.
Scope of the Baseline Analysis
The baseline analysis in Akwa Ibom, Cross rivers, Ebonyi and Oyo states will be conducted at four levels in each state: LGA, health facility and community.
Local Government Area Level:
- Malaria policies and guidelines: Establish availability and use of malaria policy documents, guidelines, SOPs, tools, job aids, and training materials in selected LGA health departments and selected primary health care centers.
- LGA-level malaria coordination: Review the functionality of malaria program coordination and management structures at selected LGA health department and malaria units, including staff strength, responsibilities and reporting, sub-committees, review meetings, among others. Examine the current practice, identify strengths, challenges and areas that need improvement.
- SME: Review existing structures, systems and processes for collection of health facility monthly summary forms (MSF), validation, entry, analysis, data quality assessments (DQA), data interpretation, and data use for decision making. Examine current practices and identify strengths, challenges, and areas that need improvement.
- Mechanism for planning and budgeting: Review human and financial resources for malaria control, the availability of LGA malaria plans, the process for developing the malaria plans and alignment with state malaria AOP, and the use of LGA malaria plans to guide implementation, coordination, and resource mobilization. Document sources of funding and resources such as malaria commodities for LGA malaria elimination activities, budgets and releases for malaria activities in last four years.
- Malaria diagnostics quality assurance: System for malaria diagnostics internal and external quality assurance (for rapid diagnostic test – RDT - and microscopy) and linkage with state level diagnostics quality assurance system.
- Referral system – Review existing referral system for malaria and availability of referral directory in the LGA.
- Health facility monitoring and supportive supervision – Availability of LGA supervisory teams, tools, frequency of supervision, funding, logistics challenges.
Health Facility Level:
- Facility infrastructure: Laboratory, drug store, space for clinical activities, equipment, and commodities stock of malaria commodities at time of visit, source of commodities, challenges with commodity supply, commodity stock-outs.
- Services: Service package offered by the health facility, especially malaria prevention, diagnosis and treatment; immunization and child welfare; ANC/delivery; and referrals.
- Malaria documents: Availability of job aids/SOPs, training manuals, malaria policies and guidelines, lab register, outpatient department (OPD) register, reporting forms, etc.
- Human resource: Number of staff by cadre, malaria-related trainings received, year of training and funding source for trainings. Supervision received from LGA, SMOH, SPHCDA, or HMB as applicable.
- Health facility attendance: OPD attendance, inpatient record, fever cases, fever cases tested with RDT or microscopy, confirmed uncomplicated malaria cases, severe malaria, treatment, antenatal care (ANC) attendance and intermittent preventive treatment in pregnancy (IPTp), and long-lasting insecticidal (LLIN) distribution for children less than 5 years and pregnant women, and NHLMIS data.
- Compare select data from source registers with MSFs and data from MSF with NHLMIS data for consistency, completeness and document data quality issues. Compare NHLMIS data with service data for fever cases tested for RDT/RDTs used; confirmed uncomplicated malaria given artemisinin-based combination therapy (ACT/ACT) treatment course used and pregnant women given IPTp/sulfadoxine-pyrimethamine-SP course used within the same given period and triangulate stock-out data.
- Data quality: process for assuring quality of data generated in the facility.
- Process for filling out MSF every month, data verification and analysis.
- Data use at the health facility level.
- Community data collection and analysis.
- Diagnostics: Availability of malaria diagnosis services, malaria diagnosis quality assurance-quality control (QA/QC), and challenges in diagnosis.
- Stock: availability of ACTs, RDTs and SPs.
- Referral system: Referral system in place for suspected severe malaria cases from lower level to higher level of care, including challenges, and gaps.
- Exit client-interviews: These interviews will be to assess the quality of services received for patients/guardians of patients with fever who received a service, and pregnant women only.
- Payment for malaria services – services paid for and services offered free of charge, and source of facility funding will also need to be assessed.
- Information will be collected from selected communities within the LGAs visited through interaction with community leaders, community pharmacists, community volunteers working in the communities, beneficiaries of services (mothers of children under five who have had a child with fever, women who have been pregnant in the last year). Information will include:
- Places where majority of the people seek care for fever (e.g. private and public health facilities, community volunteers, traditional healers, and PPMV shops, etc.).
- Places where majority of pregnant women seek pregnancy support and services during pregnancy (not delivery) and whether they received malaria related medicines/nets.
- Perceptions of services provided by health facilities.
- Community to health facility referral practices and challenges.
- Community strengths and local resources available for improving health and malaria services including seasonal malaria chemoprevention (SMC).
- Community perception on what causes malaria and how malaria can be prevented and treated.
- People’s views on how to improve malaria services in the community.
- Community level interventions, especially community case management of malaria or iCCM, SMC, current status, source of commodities, and key implementation challenges.
- The consultant should utilize mixed methods and triangulation of sources/data to ensure the credibility of key findings and recommendations from the baseline analysis. Data collection methods are listed below:
- Key informant interviews and focus group discussions with relevant individuals at the LGA, health facility and community levels.
- Health facility assessment including client exit interviews, data quality assessments and other possible tools.
- Other tools: The consultant may recommend other tools as appropriate for the analysis.
- The consultant will be required to pretest baseline analysis tools to help determine the relevance, clarity, and substance of analysis questions and the amount of time needed to complete them.
Roles and Responsibilities of the Consultancy:
- Develop a work plan with indicative timelines for the assignment. Lead the recruitment and training of field functionaries -research assistants and data collectors. Conduct all data collection including introductory meetings at the different levels of data collection. Analyze both quantitative and qualitative data. Write the draft reports, and finalize reports based on comments/feedback received from MSH and funder.
Expected Eesults from the Consultancy:
- Comprehensive baseline analysis report: The report should include an executive summary, introduction/background to the project, methodology, key findings and results, limitations to the study, and recommendations for all four states. Guidance will be provided by MSH for other specifics in the report.
- Office location: The individual consultant will work with the respective MSH state offices where the baseline analysis is taking place.
- Reporting responsibilities: The consultant will report to the following:
- The PMI-S State coordinator in the state of assignment: Daily
- The Director, Monitoring and Evaluation at MSH/Abuja: Weekly
- Travel: All travel deemed necessary to complete this assignment must be incorporated into the financial proposal to be submitted by the interested bidder.
- The period of performance for this Scope of Work shall not exceed 3 months and becomes effective from the date the consultant enters into a contract with MSH Nigeria.
- It is important to note that due to the urgency of this job, the successful consultant is expected to start work not later than one day after contract signing.
- The consultant is expected to implement the baseline analysis activities concurrently in all the four states.
- A Postgraduate Degree in Public Health or equivalent in a related field.
- Experience in health sector. However, malaria research experience will be preferred.
- Evidence of similar consultancy jobs successfully completed in the last 1-3 years.
- Demonstrated evidence of good analytical, presentation, and reporting skills.
- Excellent interpersonal, multicultural, and team-building skills.
- Ability to respond to comments and questions in a timely, appropriate manner.
- Ability to write high-quality, clear, and concise reports in English.
- Excellent organizational skills – detail-oriented and accurate.
- Demonstrated evidence of skills in data analysis, data visualization, data interpretation, and data use.
- Familiarity with, and understanding of, USAID procedures and processes.
- Experience working with, and understanding of, government ministries, departments and agencies, particularly at the state level.
- Knowledge and understanding of the local political, economic, and social context in the baseline analysis states.
- Experience working on similar assignments at the national or state level will be an added advantage.