United Nations International Childrens Emergency Fund Tender

Terms Of Reference For Institutional Contract   Title Of The Assignment Urban Phc Clinic Scheme Operator Purpose To Ensure Competitive Management Of 7 Phc Clinic Services In 4 City Corporation As Per Essential Service Package Guideline As Per Standards Location Dhaka (dncc, Dscc), Gazipur, Narayanganj  Estimated Duration Jan 2021 – Dec 2022 Reporting To Technical Supervisor Of This Assignment Health Officer   1. Background The Rapid Growth Of The Urban Population Has Increased The Huge Demand Of Primary Healthcare Services. However, There Is Huge Inadequacy Of The Mohfw Led Primary Health Care Services Provision In Urban Areas. Thus, Urban Residents Turn To Alternative Providers Of Primary Health Care, Which Include: (i) For-profit Private Providers (private Medical College Hospitals, Private Hospitals/ Clinics, Doctors Chambers, Diagnostic Centers, Drug Stores, And Quacks); (ii) Not-for-profit Organizations (e.g., Rainbow Clinics (urban Primary Health Care Service Delivery Project), Surjer Hashi Network, National Healthcare Network Of Badas, Ad-din, Gono-shasthaya Kendra, Dushtha Shasthya Kendra, Dhaka Community Hospital, Sajida Foundation, Brac And (iii) International Ngos (marie Stopes, Muslim Aid, Red Crescent Society, Etc.).   There Is A Gap In Urban Health As Identified By Some Recent Documents Including The National Urban Health Strategy 2020, (mohfw 2020a; Mohfw 2020b, Mohfw 2016; Hamid And Sabur, 2016). For Addressing These Gaps This Document Suggested Various Strategies Including Upgrading Government Dispensary (god), Setting Up Upgraded God In The Un-served And Underserved Areas, Introducing Catchment Area Based Primary Health Care, Introducing Urban Community Clinic, Introducing Mobile Clinic; Introducing Institutional Practice In The Government Health Facilities And So On. A Study Also Focused On The Establishment Of Gp System In Bangladesh For Primary Healthcare Services (mohfw 2020b). The Chatham House, A Uk Based Think-tank, Recommended For Establishing A Network Of Gp Centers Like Delhi’s Mohalla Clinics In Bangladesh.    A Group Of Experts Has Developed A Detailed Implementation Design And Operational Plan Of The Urban Clinic Model For Primary Health Care To Serve Urban Population, That Is Included In The Annex. Based On The Developed Model, The Present Tor Is To Support The Gob In The Development Of A Competitive And Sustainable System To Manage Gp Centers Focused On Performance Based Payment System To Empaneled Health Workers Whereby Promotive, Preventive And Curative Health Services Are Rewarded And The Clinics Have A Level Of Autonomy To Ensure Efficient Use Of Resources While Providing Quality Primary Health Care. The Clinics Will Be Part Of The Health System And Essential Commodities, Such As Medicines, Vaccines, Fp Commodities, Micronutrients, Will Be Sourced From The Ministry Of Health And Family Welfare.   2. Objectives, Purpose And Expected Results Objectives And Purpose Of Assignment The Objective Of Assignment Is To Setup A Competitive And Sustainable System For Management Of The Urban Clinics Including The Empanelment Of Health Workers And Establishing Comprehensive Management Of Primary Health Care Centers. The Specific Objectives Of The Assignments Are, To Establish Financial And Administrative Management System For 7 Urban Phc Clinics To Ensure Effective Service Delivery Of Urban Phc Clinics As Per Essential Service Package Guideline As Per Standards The Expected Results Of Assignment – The Contractor Will Achieve The Below Results In Coordination With Mayor’s Office, City Corporation And Ward Health And Education Committees, And With Ministry Of Health And Family Welfare (dghs/dgfp/dgnm), Financial And Administrative Management Of 7 Urban Phc Clinics Are Established. The Contractor Will Rent Or Lease A Building For The Clinic From The Lgi. The Contractor Will Define The Catchment Areas In The Ward For Each Urban Phc Clinic And Register Population In Catchment Areas. The Contractor Will Support Gob For Establishment And Management Of Functioning Clinic And Establish Effective Linkage With Primary Healthcare In Private Sector. Urban Phc Clinics Should Be Set As Per Standards And Guidelines Provided By Unicef And Government Of Bangladesh Including Empanelling General Physicians, Consultants, Recruitment Of Staff And Health Workers. The Contractor Will Set Up It Systems For Patient Registration, Administration, Account Management, Tele Medicine. Cost-effective Fiscal Management Shall Be Established As Guided By Pay-for-performance (p4p) Principle. The Contractor Will Set Up Ict Based Claim Management For Preparation And Verification Of Claim. Quality Primary Healthcare Services Are Provided. The Contractor Will Ensure Effective Delivery Of Primary Healthcare As Per Standards In The 7 Urban Phc Clinics Including Community Outreach Services. The Contractor Will Facilitate Capacity Building Of Service Providers Through Training Courses Provided By Unicef And Gob. Quality Primary Healthcare Should Be Ensured As Per The Essential Service Package For Promotive, Preventive And Curative Care For The Population In The Catchment Area – E.g. Maternal, Newborn, Child And Adolescent Health Services (mncah), Immunization, Nutrition, Non-communicable Diseases, Family Planning, Limited Point Of Care Diagnostics. The Contractor Will Establish Effective Supply Chain Management System For Essential Medicines And Logistics, Through The Ministry Of Health And Family Welfare, I.e. The Contractor Will Receive The Required Commodities From The Mohfw. The Contractor Will Conduct Monitoring And Supervision Of Day-to-day Activities Of Urban Phc Clinics Including Medicine And Other Supplies Management And Community Out-reach Services, Ensuring Quality And Accountability Of Services Using Continuous Quality Improvement (cqi) Framework. Referral System For Complicated Cases And Ict Based Integrated Health Management Information System (ihmis) Will Be Established With Support From Unicef And Gob. 3. Of Assignment   Scope Of Work The Contractor Will Establish 7 Urban Primary Health Care Clinics Where The Urban Health Surveillance System Is Operational (icddrb)[1]: Korail       Dhaka North City Corporation (dncc) (ward # 20, Dncc) Mirpur Dhaka North City Corporation (dncc) (ward # 06, Dncc) Dakshin Khan Dhaka North City Corporation (dncc) (ward # 47 – 50) Shyampur Dhaka South City Corporation (dscc) (ward # 58 & # 59 Dscc, Previously Shyampur) Dhalpur, Dhaka South City Corporation (dscc) (ward # 50, Dscc) Gazipur, Gazipur City Corporation (near Tongi) (ershad Nagar) Narayanganj, Narayanganj City Corporation, (ward # 13)   These Clinics Will Provide Primary Health Care As Per Esp And Refer Complicated Cases To The Hospitals Nearby Of The Public Health System. The Ucm Will Be Piloted As These Areas Are Populated By Low-income Households And Outside Of The Uphcsdp. Each Of The Areas Has About 100,000 Population Of Which Approximately 10,000 Slum And 90,000 Is Non-slum. The Clinics Will Be Operational In Or Close To The Slum Area. As The Scheme Will Be Universal Irrespective Of Poor And Non-poor Or Slum And Non-slum, Initially, One Urban Phc Clinic Will Be Established In Each Of The Seven Areas. Referral Services: Kurmitola General Hospital For Dakshin Khan Area And Korail, Suhrawardy Hospital For Mirpur, Mugda General Hospital For Shyampur Area And Gazipur/narayanganj District Hospital For A Selected Ward In Gazipur/narayanganj Respectively Will Considered Referral Facilities For Opd  For Services That Are Not Available At Urban Clinic, Emergency, Ipd Including Severe Acute Malnutrition (sam) Management Services.  Necessary Initiatives Need To Be Taken To Make Agreement With Theses Referral Hospitals To Ensure Service Delivery Of Referral Patients. Digital Platform Will Be Established To Maintain Referral And Back Referral Services And Track Patients. In Addition To Pocd (point Of Care Diagnostics) There Will Be Provision Of Collecting The Pathological Samples From Urban Clinic. These Samples Will Be Examined In The Diagnostic Lab Of The Referral Hospital Or Private Lab (e.g., Uttara Adhunik Medical College Hospital, Amz Hospital), Which Will Send The Reports In The Respective Gpc/urban Clinic Digitally.   Of Tasks: Specific Services Under This Assignment Are As Follows: Identify The Building Where The Clinic Will Function In The Slum Area Or Close By. Define The Catchment Areas In The Ward For Each Urban Phc Clinic Register The Population In Catchment Area, Supported By Ict System And Uhdss Data Base Of Icddr,b (where Relevant). Financial And Administrative Management Of The 7 Clinics Establish The Urban Phc Clinics As Per Set Standards In Hired Premises Or In A Space Owned By City Corporation Or Ministry Of Health & Family Welfare Within The Catchment Area.  Empanelling Gps, Consultants/specialists And Recruiting All Other Staff As Per The Guidelines (in Annex) And Provider Management: Selection Of Qualified Gps/health Workers As Per Agreed/set Criteria Empanelment Of Health Workers As Per Plan In The Annex It Systems Support For Patient Registration, Administrations, Accounts Management, Tele-medicine Etc. Claim Management (preparation + Verification) And Fund Disbursement Following The Approved Guidelines Establish Ict Based Claim Management System Digitised Billing And Payment System For The Employees Primary Health Care And Clinical Services Operations Management As Per Esp Package And Norms Of 7 Clinics Including Community Out-reach Services And Linkage With The Community Groups/platforms Engaged For Service Seeking Behaviour Change Communication And Referral, As Outlined In The Urban Health Clinic Model Attached Capacity Building Of Service Providers As Per National Norm Through Introductory Course For Gp/urban Phc Clinic Equip The Urban Uhc Clinics With Required (basic) Equipment Service Provision Of The Esp With Quality, With Details On The Opd Package, Ipd Package, That Is Focused On Primary Health Care With Promotive, Preventive And Curative Care For The Population In The Catchment Area (more Details Are Provided In The Gp Model Outline Attached): Consultations Ncdc Maternal, Newborn, Child And Adolescent Health Services (mncah) Including Immunization Family Planning Services (fp) Immunization Maternal, Infant, Child, Adolescent Nutrition Counselling Services Point Of Care Diagnostics (limited) Essential Medicines And Phc Services Supply Chain Management System For Urban Phc Clinics Management, Monitoring And Supervision Of Day-to-day Activities Of Urban Phc Clinics Including Healthcare Services, Medicine And Other Supplies Management, Maintain Hmis, Ensuring Quality And Accountability Of Services Using Continuous Quality Improvement (cqi) Framework. Referral Management Of Complicated Cases. Ict Based Integrated Health Management Information System (ihmis) Including Treatment Protocol Management, Tele-medicine, Stock Management Of Essential Medicines And Supplies, Linked To Billing And Payment. Coordination With Mayor’s Office, City Corporation And Ward Health And Education Committees, And With Ministry Of Health And Family Welfare (dghs/dgfp/dgnm), Including The Oversight Of Community Out-reach Services And Mobilization Activities. The Medicines And Medical Supplies, Including Vaccines, Fp Commodities, Micronutrients Will Be Mobilized From The Operational Plans Of The Mohfw. 4. Deliverables     Deliverables Items Covered/included Time Frame 1. Establish Up To 7  Urban Phc Clinics With Facility Readiness Coordination With Cc And Ward Committees Explore Existing Clinics Or Renting Space For The Clinic Define The Catchment Areas In The Ward For Each Urban Phc Clinic Registration Of Population In Catchment Area Set-up Clinics As Per Sop Equipment (with Unicef Support) Supplies (use Current Supply Chain For Urban Phc Through The Health System, Including Nutrition) Develop It System Branding And Awareness Raising Of The Clinics Month 1,2 & 3 2 Empanelment Of Gps, Consultants/specialists And Other Staff And Capacity Building Selection And Empanelment (contracting) Of Qualified Gps/health Workers As Per Agreed/set Criteria Capacity Building As Per Guidelines Month 1,2 & 3 3 Ict Systems Develop Ict Systems To Support For Patient Registration, Administrations, Accounts Management Develop An Ict System For The Claim Management System (claim Preparation + Verification) Develop Ict Systems For Treatment Protocol Management, Stock Management Of Essential Medicines And Supplies, Linked To Billing Maintenance Of Ict Systems Month 1,2 & 3   Ongoing (maintenance) 4 Ict Based Payment Systems Verification Mechanisms Claim Management Ict Based Payment System Including Digitised Billing System And Fund Disbursement System Following The Approved Guidelines Month 4 Onward Ongoing 5 Service Delivery Service Delivery Of The Agreed Esp Package, Including Promotive, Preventive And Curative Care Quality Improvement And Assurance System As Per Gob Guidelines And Sop Waste Management System   Quarterly Reports Month 4 Onward Ongoing 6 Monitoring And Reporting Ensure Routine Hmis Reporting From All Urban Clinics In To Dhis 2 Platform Establish Structured Monitoring System Using Real-time Data From Dhis 2 Following The Sop For Urban Phc Clinics Monthly Progress And Quarterly Output Reporting As Per Urban Health Clinic Model Summary (attached) Annual Report   Final Report Month 4 Onward Ongoing     February 2022 February 2023     5. Reporting Requirements   Inception Report Report Of First 3 Months Quarterly Output Based Report Month 4 Onwards As Per Above Deliverables Annual Report Final End Assignment Report     6. Payment Schedule   First Payment: 10% Upon Submission And Approval Of Inception Report   Second Payment: For Phase 1: On Acceptance Of Deliverables 1, 2 & 3 (after 3 Months)   Subsequent Payments As Per Service Provision Specified Under Deliverable 4, 5 And 6: On Submission Of Quarterly Progress Reports   7. Qualification Requirement Of The Company/institution/organization   At Least 10 Years Of Experience In Managing Health Service Clinics As Scheme Operation For Health Services. Experience In Private Health Service Provision Or Health Insurance Scheme Operations Is An Asset. Experience In Development, Maintenance Of Functioning Health Service Ict Management Systems Is An Asset (use Of Treatment Protocols, Algorithms, Internal Checks For Rational Prescribing Patterns Linked To Billing Options). Proven Understanding Of The Performance Based Payment In Health Care Proven Understanding Of Public Health, Population And Nutrition Programming Including Preventive, Promotive And Curative Services. Knowledge Of The Esp Of The Mohfw Is An Asset. Understanding Of Rationalizing Health Care And Understanding Of Balance Between The Need For Preventive And Promotive Health Care Versus Curative Health Care. Experience With Mohfw Hmis System Is An Asset.       [1] The Final Number Of The Clinics And Locations Will Be Finalized In Agreement With The Gob.