CCM (Comitato Collaborazione Medica) is an Italian NGO operating in Burundi, Ethiopia, Kenya, Somalia, South Sudan and Uganda, specialized in health-related projects’ implementation, either in humanitarian and development contexts.
1. BACKGROUND
The Health Sector in conjunction with Sudans’ Federal Ministry of Health (FMoH) and humanitarian actors have identified 3.9 million people to be in need of health services, 53% of whom are children. This includes 57% IDPs, 31% refugees, 9% residents and 3% returnees. The sector strategy aims to improve access to essential health services for crisis-affected people. This will be achieved by improving primary healthcare services including maternal and child healthcare, ensuring adequate and equitable access to clinical and public health interventions and improving referral systems in high priority localities. These services are currently provided through existing health facilities or where health units do not exist or are insufficient, through mobile clinics, particularly for newly displaced communities. Health services research and health care management have frequently focused on the role of supplies and personnel for the quantity and quality of health care services. It is obvious that qualified and motivated personnel are crucial for preventive and curative medical services, and vaccines as well as drugs are of utmost importance for the health of people. However, the role of health care facility infrastructure as a major component of a health care system must not be underestimated. The term ‘infrastructure’ is used in manifold ways to describe the structural elements of systems. In the context of a health care system and in reference to health care facilities, we defined “facility infrastructure” as the total of all physical, technical and organizational components or assets that are prerequisites for the delivery of health care services. It can be seen as a major component of the structural quality of a health care system. Besides, professional management is required to safeguard the functionality of all components. For instance, maintenance of infrastructure frequently constitutes a problem in resource poor countries. It is frequently neglected due to lack of funds, availability of spare parts, poor training or little availability of maintenance personnel and a culture disregarding maintenance. Consequently, the condition of assets is often rather poor and contributes to the low structural quality of health care services. This calls for a higher managerial awareness of infrastructure.
2. SCOPE OF THE SERVICE
2.1 Purpose and Objectives of the rapid assessment
The purpose of conducting a Health Facilities (HFs) assessment, which consists of all different engineering components, is to identify problems and deficiencies that are currently limiting the provision of health services at both primary (Primary Health Care Centers, PHCC) and secondary (County Hospitals) levels of the Health system. Then, based on an analysis of the findings a prioritized set of recommendations are to be made consistent with current MOH standards and guidelines (Basic Package for Health Services Delivery) for the safe delivery of primary and secondary healthcare services.
The main objectives of conducting HFs assessments are to:
• assess the condition and the status of the hospitals, PHCC and compound buildings and infrastructure;
• estimate if the HFs are over- or under-utilized;
• determine if the utilities and sanitation system are functioning and adequate for the needs of the HFs;
• ensure the availability of adequate space and facilities for primary and secondary healthcare services;
• assess if patient care is compromised by space limitations, inappropriate use of existing space and/or a combination of the two;
· advice on the best approach to designing and building hospitals and PHCC.
2.1.1 Geographical area to be covered
All CCM Hospitals and Primary Health Care Centers in South Sudan:
Madre Teresa Hospital in Turalei, in Twic County;
Tonj Civi Hospital in Tonj South, Tonj County;
Marial Lou Hospital in Tonj North County;
2 PHCC and 3 PHCU in Awerial County;
3 PHCC and 9 PHCU in Tonj East County;
2 PHCC and 5 PHCU in Yirol East County;
1 PHCC and 8 PHCU in Tonj South County;
2.2 Specific Tasks of the assessment
Specific tasks to be completed at the Hospitals and HFs include:
Determine the physical (structural) condition of the buildings;
Determine the condition of the water and waste water networks, water storage capacity and reservoirs, septic tank(s), dry pit latrines, toilets, sluices and any other sanitary systems;
Check the space used for storage of drugs, consumable commodities and equipment;
Check the waste management system;
Check the status and load of the electrical distribution system;
In close coordination with the health technical staff, assess how easy (or difficult) it is for patients to access health services, especially HIV/AIDS and TB, and the potential for cross contamination – mixing healthy clients seeking preventive services (e.g., immunization services or family planning) with infectious patients (e.g., untreated TB);
In close coordination with the health technical staff, determine the location and assess the condition of space used for treatment of chronic diseases, including HIV/AIDS and TB;
In close coordination with the health technical staff, determine the location and assess the condition of space used for maternity care (labor, delivery and immediate postpartum) services in support of prevention of mother-to-child transmission (PMTCT) of HIV;
In close coordination with the health technical staff, review hygiene practices (e.g., water taps and sinks for handwashing) in examination and treatment rooms (e.g., labor and delivery area) and environmental health control measures (e.g., is there adequate cross ventilation in examination and treatment rooms, especially those used by HIV/AIDS and TB patients);
Collect and prioritize the findings in order to link identified problems and deficiencies to potential solutions;
Develop a set of preliminary recommendations consistent with resources available for renovation/reconstruction of the HFs.
2.3 Reporting Line
The consultant will report to the CCM Country Representative for strategic coordination. He/she will work in close collaboration with the CCM Logistic Coordinator in Juba, as well as the CCM staff members of all county bases for inputs into the development of the engineering assessment.
2.4 Expected outputs of the assessment:
The major outputs of the HFs assessment visits are preparation of two reports:
1. Health Facilities Assessment Site Visit Report. This short report should be prepared as soon as possible after the HF assessment has been conducted. This report should be based, in part, on the interview with the HF in-charge, or designated representative. It should summarize the problems or issues the HF in-charge considers important, the main observations by the team, the preliminary set of recommendations and, most importantly, response to the feedback (debriefing) provided by the assessment team leader prior to departing the HF. In particular, it is important to note in this report:
• if the HF has access to other funds that may be combined with existing funds;
• what in-kind contributions the HF and/or the county health department is prepared to make (e.g., help in moving furnishings and other items as part of improving space use, cleaning up the HF or removing/relocating damaged or non-repairable equipment); and
• does the HF accept the findings and preliminary recommendations, especially with regards to changing the location of various HF activities and functions to improve patient and staff flow patterns and to make the HF environment safer for patients, staff and healthy clients?
2. Health Facilities Assessment Report. This report should include the following:
a. HFs Compound Drawings. A detailed CAD of the entire facility “as built” should be developed that includes the name of each building and use of each room/area/space. In addition, a second set of CADs should be developed that identifies proposed clinical (patient and staff) flow changes, priority renovation activities and potential areas for expansion (new
constructions).
b. Damage Take-Off sheets. A full set of take-off sheets should be provided that support the drawings and calculations for each room/building. This data is used in developing the HF renovation BOQ.
c. HF Renovation BOQ. A full BOQ should be produced that quantifies all identified requirements, including any changes in space use, additional space (if required), upgrades/repairs to utility networks, maintenance works and other improvements. (The cost estimate should be based on construction prices for Juba with a regional factor applied depending on the HF location.)
2.5 Project management
2.5.1 Responsible body
The person responsible for managing the contract will be CCM Country Representative in South Sudan.
2.5.2 Facilities to be provided by the Contracting Authority and/or other parties
The Contracting authority will be responsible for the organisation of the consultant mission, once in South Sudan and will facilitate his/her entry in the country. CCM will organise internal flights and road transport, will take care of consultant accommodation and food for the days of field visit. International flights and any another expense not mentioned in this article will not be at Contracting Authority’s charge or responsibility.
3 LOGISTICS AND TIMING
3.4 Location
The service would be on a consultancy basis and may require some activities to be conducted from distance. Visit to all field bases for engineering assessment should be conducted in South Sudan.
3.5 Commencement date & Period of implementation of tasks
The intended commencement date is 1st of June 2016 and the period of implementation of the contract will be 3 months from this date.
4 REQUIREMENTS
4.4 Personnel
4.4.1 Key experts
The required profile to participate to the tender include the following:
Proved relevant and extensive experience with a focus on engineering assessment.
Relevant qualifications and training attendance on civil engineering and/or architecture.
The consultant must have a clear understanding of NGOs policies and procedures with at least 3 years of relevant and progressive engineering and management experience.
Minimum 5 years field experience in emergency countries is a requirement. Proven supervisory and leadership capabilities required.
Demonstrated ability to produce clear, succinct policy and communication material.
Excellent written and oral communication skills in English required.
Very good communication skills.
Ability to work independently and respond to feedback in a timely and professional manner.
Excellent organizational skills, attention to detail, and ability to contribute to a team.
Previous knowledge of the South Sudanese context will be an asset.
Consultants can work individually or in a team.
4.5 Office accommodation
Office accommodation for each expert working on the contract will be provided by CCM.
4.6 Facilities to be provided by the Consultant
The Consultant shall ensure that experts are adequately supported and equipped. In particular it shall ensure that there is sufficient administrative, secretarial and interpreting provision to enable experts to concentrate on their primary responsibilities. It must also transfer funds as necessary to support its activities under the contract and to ensure that its employees are paid regularly and in a timely fashion.
The consultant is required to have his/her laptop, internet connection, training equipment and provide for his international travel to South Sudan.
5 REPORTS
5.4 Reporting requirements
The consultant will submit the following reports in English in one signed copy:
• Draft final report of maximum 25 pages (main text, excluding annexes). This report shall be submitted no later than 2 weeks after the end of the period of implementation of tasks.
• Final report with the same specifications as the draft final report, incorporating any comments received from the concerned parties on the draft report. The final report shall be provided by the latest 7 days after the reception of the comments on the draft final report as per inputs indicated in points 2.2 and 2.4. The final report must be provided along with the corresponding invoice.
5.5 Submission & approval of reports
The report referred to above must be submitted to the person indicated in point 2.5.1 who is responsible for approving the reports.
6 MONITORING AND EVALUATION
The Consultant is requested to provide the work plan set in order to meet the deadline described in points 3.5 and 5.
HOW TO APPLY:
Consultants interested should submit a proposal, including budget time line, and resume by May 28th, 2016 to: recruitmentpvs@ccm-italia.org
Please, specify in the email subject the following reference: JUBASS/2016/CNP02