Request for Proposal (RFP)

Title of Assignment: Training Needs Assessment for AUAFP Project

A.  Introduction:

Pathfinder International, in partnership with IntraHealth International, and with strategic support from the Obstetrics-Gynecology Society of Bangladesh (OGSB), the World Health Organization and University of Dhaka is implementing the AUAFP Project (USAID funded Accelerating Universal Access to Family Planning) in Bangladesh. The goal of the project is to contribute to the improved health and human capital in Bangladesh. The objective is to increase utilization of family planning services through universal health coverage. The project will pursue two intermediate results; 1) Increased qualified family planning workforce and 2) Increased availability of public sector family planning outreach contacts and services, particularly for adolescents and youth.
 
The project will support the strengthening and expansion of access to quality Family Planning (FP) services through a collaborative health system capacity building partnership with the Government of Bangladesh (GoB). The project will use a flexible implementation model led in partnership with the Ministry of Health and Family Welfare (MoHFW), including the National Institute of Population Research and Training (NIPORT), the Directorate General of Family Planning (DGFP), and the Directorate General of Health Services (DGHS). The project will operate in the divisions of Dhaka, Mymensingh, Sylhet, and Chattogram through a phased approach, beginning with six pilot districts, providing adaptive, needs-driven technical assistance (TA) and systems strengthening, and it will expand to all districts of the 4 divisions during the fourth and fifth project years.

B. Background:

Bangladesh has made remarkable strides in improving its citizens’ health over the past two decades. The country has also seen reductions in the total fertility rate (TFR; from 3.4 to 2.3), and increases in the modern contraceptive prevalence rate (mCPR; from 36.6% to 54.1%) during this period (BDHS, 2014). These gains are due in great part to commitment from the GoB in advancing to universal health coverage as outlined in the 2011 National Health Policy and the 4th Health, Nutrition, and Population Strategic Investment Plan (HNPSIP), 2017-2022.  The 4th Sector plan set the targets to decrease the TFR from 2.3 to 2.0, increase CPR from 62% to 75%, increase LAPM share of method mix from 8% to 20%, reduce discontinuation rate of FP method from 30% to 20% and reduce unmet need from 12% to 10%. The FP2020 targets are also aligned with the 4th Health sector targets.

However, there are key challenges in achieving these targets; including inequities across geographic areas and among age cohorts. For example, while mCPR nationally among married women is at 54.1%, it is much lower in the AUAFP project focus divisions of Chattogram, Dhaka, Mymensingh, and Sylhet. To overcome the current mCPR plateau, the project needs to address the range of social, cultural, and structural factors that underpin these inequities. The public sector is the main provider of modern methods and faces many structural challenges related to its health workforce and facilities. Health facilities at all levels need be prepared to provide FP services yet only 57.4% of clinics have staff who had ever been trained on FP (BHFS, 2014) services. There is limited in-service training and no formal continuing medical education (CME) requirements for FP and health professionals. Furthermore, the FP training mandate is held by three entities: NIPORT, DGFP and DGHS, which results in the need for better coordination of training programs.

To overcome these challenges, both the Bangladesh Health Workforce Strategy 2015 and the 4th Health sector plan and its relevant Operational Plans have delineated the importance of enhancing capacity of NIPORT along with its institutes and DGFP facilities for imparting need-based training for developing high quality health service providers for public sector. Accordingly, the Operational plans mentioned need for updating training curriculum, instruction manuals, guidelines and developing e-learning tools/courses for competency based and in-service training. There is need for a follow-up mechanism for strengthening supervision and on the job support for different cadres of service providers to post-training to ensure providers are applying their FP knowledge and skills. Capacity building of managers and supervisors, accreditation/certification of health professionals, strengthening capacity of training institutes  and need for a centralized training management/human resources information system (TMIS/HRIS) systems are also mentioned in the Operational Plans.

C. As a part of the preparatory activity the project is planning to conduct a comprehensive Training Needs Assessment (TNA) with following components;

• Determine FP provider competency-based skills, knowledge and practice and identify gaps that can be met through training for different cadres providing FP services at all levels. Specifically, to identify the gaps and strengths against desired quality performance with special attention to Adolescent and Youth Friendly Services (AYFS) and gender. Determine the root causes of gaps and requirements of training to fill those gaps
• Conduct capacity assessment and inventory of training institutes including an assessment of the organizational and management capacity of training institutes, trainers’ competency to develop and deliver competency based  FP training and training and learner resources. Assessment and inventory of training institutes/facilities of NIPORT and DGFP at national, district and Upazilla level.
• Assess needs and perceptions of in-service competency-based training, e-learning, on the job mentorship training, relevant continued medical education and mobile communication-based learning for FP providers.
• Assess FP supervision and mentoring at multiple levels of DGFP and DGHS services including the training and performance of supervisors to understand their training needs and gaps. Map how supportive supervision and mentoring is currently working at field levels.
• Examine and map career pathways for FP providers’ as a tool for motivation and retention. Document the reasons for high attrition or turnover.
• Use tailored existing tools (e.g., IntraHealth, Pathfinder. WHO’s AA HA! guide, and other relevant Health System Strengthening guides) to identify key challenges, bottlenecks, strengths, and identify priority areas of training institutes of NIPORT, DGFP and DGHS.

D. Potential methods and respondents for the TNA:

• Desk review for each components of TNA
• Key Informant Interviews (KIIs) of relevant government officials at NIPORT, DGFP and DGHS at national, district and Upazilla level (KIIs).
• KIIs of FP trainers, facilitators, managers, administrators at training institutes/facilities at NIPORT, DGFP and DGHS at national, district and Upazilla level (KIIs)
• Interviews/survey of FP providers (various cadres) at national, district, Upazilla and union level (both quantitative and qualitative interviews)
• Training facility inventory and KIIs with supervisors/ mentors (Mohammadpur Fertility Services and Training Centre and Maternal and Child Health Training Institute at national level, and 4 Family Welfare Visitors Training Institutes, 5 Regional Training Centres and 3 Family Planning Clinical Quality Supervision Team- Quality Improvement Team in 6 pilot districts)

E. Geographical locations for TNA and Sampling plan:

The TNA will take place at NIPORT, DGFP and DGHS training institutes/facilities and health facilities at national level and in following six districts;

• Dhaka
• Tangail
• Mymensingh
• Chattogram
• Rangamati
• Sylhet

F. TNA questionnaires and tools:

The AUAFP project team will draft the necessary questionnaires, checklists and tools. Consultant LOE would be only for finalization of the questionnaires and field testing before conducting the TNA.

G. Roles and Responsibilities:

The Consultant will be responsible for the following tasks: 

• Reporting to the Sr. Technical Advisor, HRH & CB, AUAFP project the consultant will provide TNA management and technical leadership.
• Finalize the sampling and data collection plan, including:
• Finalize the protocol, interview guidelines, consent forms, checklists and all assessment materials.
• Meet relevant key stakeholders and select health facilities to inform the finalization of the materials and overall plan.
• Finalize and test data collection instruments
• Develop and implement a data analysis plan using appropriate software
• Manage data collection teams, including training of field staff; provide overall leadership and guidance to ensure high quality and consistency
• Conduct data collection
• Ensure participant confidentiality and safety
• Manage data analysis, including:
  • The cleaning and proper entry of numerical data
  • The processing and entry of text data into the database
  • Synthesize and analyze data
  • Develop and present a preliminary report to AUAFP project and stakeholders to be carried out within 7 days of the end of data collection.
• Write the final report that will be reviewed and accepted by the Project Director, AUAFP project for dissemination to MoHFW, USAID and relevant key stakeholders.

H. Timeline:

The consultant under the guidance of the Sr. Technical Advisor, HRH &CB, AUAFP project will conduct the tasks listed below.  It is estimated that the consultant will require the following LOE.   

I. Consultant Qualifications:

AUAFP project is seeking applications for a consultant team to carry out this assessment. The Team Lead Consultant will have a combination of the following skills:

Required:

• Advance degree in public health/Anthropology/Sociology etc. or any relevant field   PhD strongly preferred. 
• Significant experience (minimum 10 years) developing protocols, designing study instruments and tools and leading   mixed methods research.
• Strong skills in qualitative and quantitative methodology including surveys, focus group interviews, in-depth interviews, structured observations etc.
• Expertise in qualitative and quantitative software such as SPSS, STATA and  NVivo or Atlas.ti for data analysis
• Experience in participatory research that includes working with stakeholder groups that involve MoHFW, NIPORT, DGFP DGHS, and building local capacity to carry out assessments
• Demonstrated ability to manage field teams and supervise data collection and analysis
• Superior writing skills
• Recent certification (not more than 2 years old) on human subject protection

J. Key deliverables of the Consultant:

The consultant will provide the following deliverables:

• Final TNA protocol with tools/ instruments, data management and analysis plans, within 10 days of hiring.
• Training plan, schedule and materials for training of local staff in data collection
• Initial draft report/ PowerPoint presentation of key findings and recommendations given to stakeholders and MoHFW, NIPORT, DGFP, DGHS to be carried out within 15 days from the end of data collection.
• Final draft of report to be submitted to AUAFP project and stakeholders for review within 30 days of completion of the entry of all data into the respective databases.
• Final report with integrated feedback from AUAFP project and stakeholders within 5 days of receipt.

All data files that contain raw data including but not limited to: recordings, field notes, completed transcripts, and data analysis files (i.e. all software files are due at the end of the contract). Where applicable the consultant will be required to submit expense reports with supporting documentation in line with IntraHealth International/ Pathfinder International Financial Policies and Operating Standards (due at the end of the contract).

K. Proposals and cost bids should include the following:

• 5 pages proposal reflecting understanding of the assignment, methodology, analysis plan, timeframe along with narratives that outlines how the assessment will be carried out.
• Detailed budget that includes LOE for the entire assignment, as well as, the cost of pre-testing, data collection, data analysis and report writing. 
• Budget ancillary costs with a budget narrative to justify the expenditures
• CVs of team members
• Previous experience carrying out similar research
• Three traceable references for similar work carried out
• Sample report from previous research

L. Payment Schedule:

Payment of the total amount of fees will be made in intervals: (i) 25% at signing of contract, (ii) 30% first draft of final report; (ii) 45% to be paid upon completion of the entire SOW – which may/ may not include attending forums and making presentations of key results.