Request for Proposal for Study on Quality of Care for Tuberculosis Program 184 views0 applications

Background

Although significant progress has been made to eliminate TB as a public health burden, TB still remains one of the leading causes of morbidity and mortality from an infectious disease. For instance, 1.5 million people die from TB in developing countries every year and approximately one quarter of HIV related deaths are due to TB.[1] Despite the substantial progress made to achieve a world free of TB, WHO estimates that almost 3 million cases are missed each year – not diagnosed, treated or reported to National TB Programs. Additionally, the rapid emergence of multi-drug resistant TB (MDR-TB) has the potential of reversing the two decades of progress mitigating the impact of TB.

Globally, prompt detection and appropriate treatment of patients is a central strategy and approach to control the disease and is the centrepiece of most national TB program strategies in high burden countries. Successful treatment resulting in cure is possible when the correct drug regimen is administered completely. In response, TB programs are increasing their efforts to improve the quality of diagnosis, care and treatment in addition to the focus of improving access to TB care. Improving basic standards of TB care can attract more clients by ensuring the clients or patients receive the care that they deserve and that providers offer better services, improve adherence, diagnosis and treatment and reduce lost to follow-up rate ultimately contributing to reducing the burden of TB disease.

Collaborating Partners

The Study on Quality of Care for TB program is being implemented by the MEASURE Evaluation a USAID funded project in collaboration with the Federal Ministry of Health through the National Tuberculosis and Leprosy Control Program.

Study Objectives

The success of universal health coverage and end TB at the country level and worldwide will depend on (1) the service capacity of facilities to provide the TB and co-morbid services (2) the management systems to support a minimum standard of quality for TB related services, and (3) the capacity of the TB and/or health sector logistics systems to provide a reliable and uninterrupted supply of the commodities required as well as minimize the infection control practices that may expose patients to danger.

The purpose of this study is to measure the quality of care for a TB program at the selected facilities and to provide actionable results for the NTLCP to develop program or interventions to improve TB service delivery.

The study objectives are to:

• Assess the levels of patients’ awareness and satisfaction regarding TB services
• Understand providers’ needs in provision of TB services
• Examine the current condition of sample facilities under which TB care is delivered regarding the availability of skilled providers, equipment and organizational structure
• Determine the quality of services provided by facilities and measure to improve the quality
• Suggest measures to improve the quality of TB services
• Measure the extent to which an enabling environment has been created to support the facility in providing quality TB related services

Study Design

An underlying consideration in the design of this study is that patients’ perceived satisfaction influences service utilization and eventually their health outcomes. As a result, the study design seeks to conduct a facility audit, interview TB providers, clients receiving TB services and a review of patient records.

Study Location: The study will take place in the 12 States where USAID/Nigeria is providing support to the delivery of TB services. The States are Akwa-Ibom; Bauchi, Benue, Cross River, Enugu, Kano, Kastina, Nigeria, Lagos, Osun, Ondo and Rivers.

Sampling: The study will use a dual-frame sampling to identify study facilities. Firstly, a listing of large health facilities providing TB-related services will be used wherever it exists either based on master facility list or a list available at the national TB program office. Secondly, the National TB program and other relevant authorities or stakeholders will help to identify other TB service delivery points that satisfy the criteria that will be numerated. The sample will include roughly 150-180 facilities.

Within the selected facilities, service providers will be randomly selected for interview while exit interviews will be conducted for 4-5 patients or clients that visited the facilities on the data collection day.

MEASURE Evaluation and National Tuberculosis and Leprosy Control Program of the Federal Ministry of Health will work with the successful research firm to finalize the sampling of the facilities, service providers and patients to be selected for exit interview.

Activities and Responsibilities for the Research Organization

The Research Organization has overall responsibility for organizing and managing the field activities for the survey, in coordination with the MEASURE Evaluation and NTLCP. The Research Organization will be directly responsible to the Principal Investigator and designated coordinator from the NTLCP while the in-country MEASURE Evaluation’s Survey Manager may be directed to provide oversight functions on the Local Research Organization.

Specifically, the Local Research Organization will be responsible for the following activities:

1. Country adaptation of data collection tools
2. The tools should be adapted according to the national TB guidelines especially for TB algorithm screening and diagnosis, infection control, treatment and drug regiment to support country standards. This will done in collaboration with NTLCP and MEASURE Evaluation.
3. Survey Set-up
4. Identify potential data collectors and supervisors for training (numbers and background required will be provided by MEASURE Evaluation and NTLCP) and arrange for the selected persons to be available for the pretest, main training and data collection
5. Pretest, training and fieldwork

• Work with MEASURE Evaluation to prepare tablets with software and download of electronic data collection forms
• Arranging all logistics for pretest and main training, including

o Coordination with NTLCP and TB Challenge for their participation and introduction letters to facilitate access to facilities for training practice

o Printing all questionnaires and training documents

o Arranging venue and supplies

o Facilitation of training and practice sessions

o Revision of tools based on feed-back

o Final selection of data collectors, team leaders, and Field Supervisors

o Arranging all logistics for field work including

o Communicating with States about the survey and ensuring teams receive supporting letters and facilities are informed of the upcoming survey

o Ensuring availability of necessary cash and copies of data collection instruments to implement field work

o Making field work assignments

o Developing field work schedule and making recommendations for changes in order to improve the logistics and efficiency of the field activities to the survey TA and ME/JSI

o Ensuring data quality checks are carried out as per the protocol

o Ensuring field work is in full adherence to the protocol, including checking questionnaires for completeness prior to sending to Lagos for data processing

o Supervision of field work, using tools agreed upon

• Arranging all logistics for field work and ensuring field work is in full adherence to the protocol, including checking questionnaires for completeness prior to submitting to the server.
• If electronic data collection is not available the Research Organization will be responsible for the following data management activities in collaboration with MEASURE Evaluation.

o Arrange all logistics for data management including: identifying data entry staff and supervisors; ensuring adequate number of computers and database security.

o Develop data entry screens and programs with internal range and consistency checks (TA will provide input for internal range and consistency checks)

o Identify possible data errors and develop a system for checking and making corrections as needed

o Clean database

o Based on the current data element in the questionnaire, assume a data entry person will enter average of 5-questionnaire per day. This should guide in the estimation for the data entry clerks and budget as well as number of days. Remember to factor in the data cleaning and quality check. The in-country team will be required to spot-check the data entry regularly.

o Data validation

Timing

Final dates will be agreed upon once the successful RO is identified however the implementation period is between April and May 2017. It is expected that the data collection should be completed by not later than May 24, 2017 and the data received by MEASURE Evaluation no later than May 31, 2019. Research organizations are requested to submit a timeline based on the above activities.

Deliverables

• Timeline of activities
• Signed contract and agreement between MEASURE Evaluation/JSI and Research organization
• Final list of sampled facilities and description of the sampling procedures for service providers and patients as well as guidance for the record review.
• Final questionnaires based on the comments and suggestions from pre-test (print and electronic form as appropriate)
• Letters of IRB approval from the Ethic committee of the Federal Ministry of Health and JSI internal review board endorsing the study
• Training report for the data collectors and supervisors
• Report describing pre-test results, data collection procedures, supervisor observations/comments, and limitations/problems encountered

• If electronic data collection forms are NOT used the following deliverables are required
• Cleaned and fully labeled data set (on CD or submitted electronically) in SPSS and/or STATA
• A copy of the codebook and any other data documentation for data analysis and entry
• All completed paper questionnaires submitted to the MEASURE Evaluation office

Selection Criteria for Proposals:

Proposals will be reviewed based on their overall technical merit. The following criteria will be used:

• Demonstrated capacity and experience of the organization to conduct similar surveys and to complete activities within the stipulated timeline
• Qualifications and experience of key survey personnel
• Experience in use of electronic platform for data collection and availability of electronic equipment for data collection
• Budget clarity and justification

How to apply:

Quotation

Interested and qualified research organizations should present bids directly to MEASURE Evaluation. All bids must be received no later than March 24, 2017. Bids may be submitted electronically to [email protected]. Alternatively, proposals may be mailed or faxed to:

Alec Moore

16^th Floor, 1616 N. Fort Myer Drive

Arlington, VA 22209

USA

Tel: 1-703.528.7474

Fax: 1-703.528.7480

Bids are to include:

• A detailed description of the proposed activities (pretest and tool revision, training, monitoring of the field work, data quality assurance, etc.)
• Detailed budget;
• Résumés of the key personnel of the organization;
• Provide experience in the use of electronic or tablets in data collection
• Statement of organizational capacity including: 1) reports of similar surveys coordinated in the past six months (preferably) or in the past year.