Terms of Reference for conducting an Effectiveness/Outcome study of the project “Facilitating access to health for factory workers through an insurance system”

1.  Background & rationale
SNV is an international not-for-profit development organisation. Founded in the Netherlands 50 plus years ago. We have built a long-term, local presence in 28 of the poorest countries in Asia, Africa and Latin America. Our global team of local and international advisors work with local partners to equip communities, businesses and organisations with the tools, knowledge and connections they need to increase their incomes and gain access to basic services – empowering them to break the cycle of poverty and guide their own development. By sharing our specialist expertise in Agriculture, Renewable Energy, and Water, Sanitation & Hygiene, we contribute to solving some of the leading problems facing the world today – helping to find local solutions to global challenges and sowing the seeds of lasting change. In 2015, SNV improved the lives of over 8.2 million people, and from 2016 to 2018 we will improve the quality of life for over 20 million.

SNV Bangladesh had received a grant from the  Embassy of the Kingdom of Netherlands (EKN) for “Promoting SRHR through Inclusive Business Practices within Ready Made Garment (RMG) Industry in Bangladesh” which is branded as ‘Working with Women’ -a pilot initiative (May 2014-July 2017). The aim of that piloting was to test viable business solutions to improve workers health while Sexual and reproductive health rights (SRHR) are the priority. SNV invited interested private sector and NGOs to offer innovative business model which would ensure affordable, accessible and available health services to the worker. One of the model was Health Insurance model which was piloted though “Pragati Life Insurance Limited”.

Furthermore, SNV replicated the same model with funding support from Carrefour Foundation and this is in operation since 2017. This is implemented at five factories located at Gazipur through two Private Insurance Company “Pragati Life Insurance Limited” and “Alpha Islami Life Insurance Limited”.

We are now seeking the services of a consultancy from Educational Institute/Research Institute/Firm or individual Consultant (Local/International) for conducting an assessment of the project “Facilitating access to health for factory workers through an insurance system” funded by the Carrefour Foundation. Detail project context will be shared with the selected firm/individuals.

2. Methodologies:
The key objectives of this study are as follows:

  • To assess the outcome and effectiveness of the CF funded ‘health insurance’ project in terms of i) improvement of workers (female and male) knowledge/awareness, attitudes and practices on Health especially in SRH, and ii) improvement in business outcomes of the factories implementing the project;
  • To identify conceptual and implementation gaps/challenges and inform measures and systems for improvement

Study design and tools
The 1st component of this study would be a quasi-experimental: cross-sectional research design to estimate the project intervention’s short term impact/outcomes on Insurance beneficiaries’ health knowledge, service utilization, and wellbeing outcomes/short term impact. An example would be a study where project’s key beneficiaries who are working in intervene factories and who are not in intervene (control) factories are separated into groups. This component of the study would want to see how many (percent) of these RMG workers (Female or male) are utilizing/benefiting through health insurance facilities. This component would have four total groups - one for each sex (female or male) group who are working in intervene/treatment factories and one for each sex group who are working in control/comparison factories. Conclusions (of this component) about the effect/short term impact of availing ‘health insurance facilities’ on ‘health & well-being of the worker’ would be based on the information gained from these groups.

Survey CTO is based on Open Data Kit (ODK), the most powerful and widely-used open source platform for data collection. It is a mobile platform designed for rigorous research or M&E projects, and other data collection efforts, in field settings. SurveyCTO/ODK facilitates the collection of high quality, secure data – even in offline environments. Instead of paper-based survey, SurveyCTO/ODK should be used through mobile devices (Tablet computer/Smart phone) for capturing data of this component of the study.

Study Population sampling and technical notes (for 1st  component of the study)

Stratified-systematic random sampling would be used to draw a sample of female and male factory workers of reproductive age (18-49 years old) from each of the selected factories. Respondents will be interviewed on a range of SRH and maternal health, FP, and other health knowledge, access, and utilization issues. Absence at the workplace and it’s causes might be asked. The total sample for this component would be 800-850 and for the each arm (treatment/control) would be 400-425. The sample sizes will be calculated to meet the criteria of 95% confidence level; 5% margin of error and 1.1 as design factors (since random selection will be used at last stage). Other key population characteristics would be considered for determining alternative sample size. Male-female desegregated data would be preferred for getting most reliable estimates.
Each interview would be last for 20-25 minutes. However, the indicative parameters/variables/issues would be as follows: socio-demographic information (around 15 questions); Knowledge/Awareness about health care (5-6 questions); availability, accessibility, affordability & satisfaction with the availability and quality of health services (two sub-sections with 32-34 questions); Health Insurance scheme (12-13 questions). A physical observation would be also conducted on some key basic needs (8-10 questions capturing through an observation check list).
However, at this stage, research firm/individuals are requested to propose their alternative study design or methodologies (if any) with proper justification.

Special note: Endline of ‘Working with Women’ project would be considered as baseline of this component.

The 2nd component of the study would be a cost-benefit analysis/“Return on Investment (ROI)” based on secondary data from factory and to gather their perspectives on the implementation and impact/outcomes of the project interventions on workers’ health and factories productivity.
Indicative parameters for component 1:

  • Total Worker;   2. New Recruitment;  3. Sick Leave;  4. Casual Leave; 5. Other Leave including Earned Leave;  6. Migration;  7. Absent with main reasons;   8. Total Production (Pcs);  9. Average SMV (Standard Minutes Value) SNV will provide support to collect secondary data for this component.

The study will be conducted within three months. It will be conducted in three pre-selected treatment and three control factories in Dhaka and Gazipur districts covering a period of 16 months, including 12-month intervention (1st year) period. The breakdown of factories is as follows:
• Three intervention factories (large/medium-sized), where the project is being implemented between 2017 and 2019.
• Three comparison factories (large/medium-sized), where the project would not be implemented before the completion of the study.

The intervention and control factories will be proposed by SNV. However, research firm/individual will finally select the studied factories in consultation with SNV.

3. Scope of work:
This consultancy will measure the effectiveness/outcomes of the implementation of the actions through health insurance scheme and assess whether the business results (short term Impacts and Outcomes) are achieved or yet to be achieved, identify bottle-necks or propose corrective actions. The prime focus of the study is component 2 and it is expected that the research firm/individual comes up with a clear analysis/research tool and make the best measurement of business results.
Some of the activities expected from the research team/individuals but not limited only to this list would be:

  • Review the project and relevant documents [project proposal, progress reports, Service statistics, collected business data (for component one by SNV), previous similar studies reports etc.]
  • Consultation/desk review with SNV/project management/partners/donor
  • Collection of data /information from RMG workers/management and other key stakeholders (Two relevant insurance companies, different service providers and RMG factory workers/management).
  • Analyse primary and secondary data and prepare report for SNV/donor

4. Timeline
The duration of the assignment will be three months (60 working days) starting from the date of contract signing. The expected duration would be 1st February- 30th April 2019

5. Deliverables and reporting responsibilities
Key Deliverables

The firm/individuals will be responsible for producing the following deliverables:

  • Revised research/study approach/methodology (if required) and draft schedule of field activities (prior to field work)
  • Draft and final questionnaire(s)/tools (both Bengali (Bangla) & English version) to be used during interviews/discussion (prior to field work)
  • Inception report (soft copy)**
  • Detailed Study Report Outline and Draft PowerPoint briefing (soft copies)
  • Raw and final data set with ODK application
  • Final PowerPoint De-briefing and initial full report draft (soft copies)
  • Final/cleaned data set (in STATA and SPSS syntax with proper labelling)
  • All tables/graphs/diagram/matrices used in report (soft copies)
  • Final Report (soft copy) following standard reporting format (within 2 weeks of receiving SNV/Donor’s comments on draft report).

**An Inception Report will have to be submitted by the firm/individuals prior to the development of study/review design for consultation and finalization in consensus with SNV/donor. The language of the Report and all other deliverables is English.

Reporting responsibilities

The consultancy firm will be responsible to the Team Leader of the project or her/him duly appointed designate. The consultant(s)/firm agrees that information obtained or learned while working on the assignment is proprietary of SNV and is confidential. However, the agency can use those data in further research with prior permission of SNV. M&E Advisor and IB Advisor of the Project will provide necessary technical guidance.

6. Payment condition:
The consultancy firm/ consultant(s) will be paid 30% of the total fee upon signing of the contract. Another 30% of the total fee will be paid upon submission of the ‘Draft Report’. The remaining 40% will be paid after successful submission of the ‘Final Report’ within the stipulated timeframe.
All fee and costs are to be expressed in Bangladeshi Taka only. Tax and VAT will be deducted at the time of payments as per the law of the ‘Government of Bangladesh’.

7. Submission of Proposals
The firm/consultant(s) needs to submit/send electronic version or softcopies of (signed and scanned) technical and financial proposal considering scope of work. The Technical Proposal should contain inter alia; organizational or personal profile (s) including relevant experience, a complete description and explanation of the proposed methodology for the assignment including detail work plan, time-line, staffing, names and qualifications of allocated personnel including key personnel CVs and any other resources that the consultancy firm/individuals might deploy to execute the assignment and achieve the objective. The Financial proposal should stipulate the fees for the assignment. The subject line of the email should be written as Conducting Effectiveness/Outcome study of Facilitating access to health for factory workers through an insurance system”. Please send of your proposals to bangladesh@snv.org no later than 19th January 2019.

For any clarification, please contact through this email address: mchowdhury@snv.org