Consultants at the Association for Reproductive and Family Health (ARFH)

Reference Code: NTP-CEAS-GF-2016
Location: Abuja, FCT, Nigeria
Contract Type: Short-term consultancy for the Global Fund NFM TB/HIV Grant
Duration of assignment: 10 days (Max.). Commencement date: 28th Nov, 2016
Report to: ARFH M&E Coordinator

General Objective

• The main of the consultancy is to assist the development of study protocol for assessing of cost effectiveness of Tuberculosis diagnosis and treatment in public and private facilities in Nigeria.
• This will include estimation of (a) cost per patient cured/completed treatment, (b) cost per death averted and (c) cost per disability adjusted life year (DALY) gained. Comparison will also be made between the different levels and categories of health facilities viz-a-viz: within public health facilities (primary, secondary and primary); private (for-profit and not-for profit private facilities) and between private and public health facilities providing Tuberculosis services.

Description of the Assignment
Suggested methodology:

• The Cost effectiveness study will be incorporated into the a national survey titled “Determine the Proportion of TB Patients and their Households experiencing catastrophic cost due to TB” which is due to commence soon. The following are the main objectives and scope of the catastrophic cost survey:

Primary Objectives
The primary objectives of the survey are:

• To document the magnitude and main drivers of patient costs in order to guide policies on cost mitigation for the purpose of reducing financial barriers to access and adherence
• To determine the baseline percentage of diagnosed TB patients treated in the network of facilities under the NTBLCP and their households, who incur direct and indirect costs beyond a defined threshold of their annual income.

Secondary Objectives
The secondary objectives are:

• To enable reporting on the 2020 End TB Strategy target that no family affected by TB will incur total (direct and indirect) catastrophic costs as specifically defined in the context of this work.
• To determine the correlation between patients incurring costs above different thresholds of annual household income and dissaving, in order to assess if the measure of dissaving is a sufficient metric of catastrophic total costs.
• To assess costs for specific subgroups, for example disaggregated by type of TB (MDR vs. drug-susceptible TB, etc), age, sex, urban/rural and income.
• To determine the association between costs incurred and TB treatment outcomes

This study will be conducted simultaneous in consonance with the catastrophic cost and in will be implemented in selected LGAs in 22 states of the Federation. Details of the methodology and scope of catastrophic survey can be obtained upon request.

This assignment will be undertaken by the consultant and will be supported by the ARFH M&E Coordinator and members of the National Expert Team on the Catastrophic cost study. The consultants will be primarily responsible for the writing and submission technical reports.

Tasks for the Consultants:

• Development of the full study Cost effectiveness study protocol
• Harmonize the above study protocol with the existing survey protocol and tools on Catastrophic cost
• Facilitation and presentation of study protocol and tools to National Expert team on TB Catastrophic cost survey.
• Final technical report for this assignment

Required outputs/Deliverables
The deliverables necessary to this assignment are:

• Final survey protocol with detailed workplan and survey data collection tools

Duration of the Contract

• The time frame for this contract is 10 days. (This refers strictly to active working days on the part of the Consultant)

Expert Profiles
The external technical consultants must have the following skills and qualifications:

• Advance degree in Health economics (Master’s/PhD) or related field in addition to basic graduate degrees of relevance to public health.
• Previous experience in the successful conduct of economic evaluation and cost analysis in health in Nigeria and/or elsewhere in the developing countries.
• Evidence of technical capacity to lead a research team
• Good knowledge and experience of the Nigerian health system and Tuberculosis control programme.
• Good people management skills
• Excellent facilitation skills
• Excellent writing skills