TERMS OF REFERENCE (TOR)
Formative Research for Regional Chapter
Making Bangladesh’s Healthcare Systems More Responsive and Participatory
Bangladesh Health Watch
Funded by Sida

Introduction

In the health sector, a strong civil society voice has the potential to influence and positively impact on social exclusion and health inequity through stronger participation, active monitoring and increased accountability and transparency. It can also play a role in refocusing healthcare systems according to health rights and social welfare goals to impact quality of life of the citizens and also provide citizens the power, especially the marginalized and poor, to influence policy decisions. 

In the vacuum created by the absence of a strong, thriving civil society movement in the early 2000, Bangladesh Health Watch (BHW) was established in 2006 as a multi-stakeholder civil society body dedicated to improve the health system in Bangladesh through evidence-based critical review of policies and programmes, and recommend appropriate actions for change.

BHW began with the publication of a series of reports, the Bangladesh Health Watch Reports, which identified the most critical challenges to the health sector at particular points of time and published insightful situation analyses leading to practical recommendations, based on evidence from existing secondary resources and primary research. BHW is also engaged to gather evidence through regular research for evidence based advocacy on topical issues to improve the situation related to quality of care, accountability and equity. BHW is poised to form Regional Chapter at district level which will act as citizens’ platform to hold government (and other actors) accountable for their major health sector commitments their catchment areas.

BHW is governed by a Working Group (WG) and an Advisory Committee provides strategic guidance to the WG. The Secretariat of the BHW is located at the James P Grant School of Public Health, BRAC University.

This research will provide an in-depth understanding about the context to form Regional Chapter and a guideline that, how the Regional Chapter can achieve its selected objectives smoothly. This Terms of Reference is to hire a consultant/ firm to carry out a formative research for the Regional Chapter.

Overview of the Project

BHW is implementing the three years project, `Making Bangladesh’s Healthcare Systems More Responsive and Participatory’ with the financial assistance of the Swedish International Development Cooperation Agency (Sida) since December 1, 2019.

The Project Goal: To strengthen the healthcare system so that it is more responsive to people’s needs and demands.

The specific objectives of the project are:

  • To enable civil society platforms/individual voices to hold government and other stakeholders accountable to major health sector commitments
  • To carry out evidence-based advocacy to improve situation of quality of care, transparency and equity especially in hard-to-reach, poor areas, particularly for women and young girls
  • To enhance understanding of duty bearers on issues related to quality of care, accountability and equity.

To achieve the ultimate result the project has three pronged strategies, which are as follows:

  • The first stream of work are planned activities to hold the government accountable in three specific areas: a) meeting the promises of the published manifesto of the political party in power; b) allocation for health in the annual national budget; c) incorporating health care users, especially feedback from women and girls in programme planning and reviews of the national sector-wide health programme.

The Regional Chapters of BHW is planned to be established under this stream of work.

  • Generating evidence on topical issues in the areas of quality of care, transparency and equity, followed by evidence based policy advocacy.
  • The third stream of work will entail disseminating the findings of various research/review to programme planners and managers as well as the general public with the intent of generating debate and discussion.

Background of this research

At district level BHW is intended to hold government accountable for its commitment in health sector through Regional Chapters. The Regional Chapters, which are in the process to set-up in 8 districts of 8 divisions, will be composed with 8-12 members each, including at least 4-6 women. The Regional Chapters will be based in a district headquarter and will ‘adopt’ a selected upazila and union within that district to reach out to more remote communities. Each chapter will maintain close contact with those remote Upazilas and unions, including one or more community clinics in the area to remain aware of health situation at those sub-regional levels and bring up any significant observation from those sub-regions for discussion/action at the regional/national level. The Regional Chapters will identify specific problems in the areas of quality of care, accountability and equity in the respective region. In the process, equity will be explored in terms of socio-economic indicators, e.g., gender, income levels etc. The Chapters will be tasked to initiate actions to mitigate the issues unearthed, propose solutions and follow up implementation. If issues cannot be solved at local level, the Chapters will then raise the issue with BHW secretariat which will initiate appropriate action, if feasible.

To manage every day activities of Regional Chapter BHW will work closely with NGO/Civil Society Organization or a medical college/university, who will act as the Host Organization for the Chapter. BHW is exploring a sustainable platform that local people/network uphold and own it for the welfare of the vulnerable people. It is evident that project based initiatives were taken previously on quality, accessibility and equity based health services for the marginalized and vulnerable population however it works up to the project period and eventually it is seen to go back to the previous state after the project period.

BHW wants a clear picture from the region of setting up such a chapters a guidance on how to form Regional Chapter, who to include, how it will function beyond the project period, who would be the Host Organization etc.

The objective of Formative Research of Regional Chapter

The objectives of this assignment:

  •  Identify a list of potential NGOs or institutions to be act as a Host Organization;
  •  Identify ways how a Regional Chapter  act as a civil society platform to monitor the government health services in the areas of quality of care, accountability and equity;
  • Identify how a Regional Chapter could collect public opinion ensuring that the voices of women and girls are heard, and collect feedback on quality, transparency and equity of service access/utilization from the district, upazila and union levels;
  •  Provide a clear guideline to BHW of the context and usefulness to form a Regional Chapter in the selected district;
  • Explore how the regional chapters can be sustained in the long term. Instead recompense to the members what would be the other ways to make them active within this platform.

The relevant information from the Formative Research may be used as a baseline to assess the effectiveness of Regional Chapter.

Districts to be visited:

  • Sylhet Division: Sunamganj District
  • Rangpur Division: Kurigram District

Methodology

The methodology of the assignment will be proposed by the researcher. But, is expected to follow a participatory and consultative approach ensuring engagement of local NGOs, Civil Society members, members of different management committees of government health institutions, government service providers, journalists, teachers, and also with the BHW team. The researchers must review relevant literatures and visit the selected districts and collect information and data using the specified methodologies.

Deliverables

  • Submit final research report (both soft and hard copy) in English with all relevant annexures;
  • List of the probable NGOs or institutions to be act as the host NGO;
  • List of the potential members for the Regional Chapter;
  • Share the findings with BHW WG and selected guests;
  • Incorporate the feedback and recommendations and submit the final report (both soft and hard copy).

Tentative Timeline

Key activities Timeline
Week 1 Week 2 Week 3 Week 4 Week 5
Consultations with BHW team and submission the inception plan XX        
Literature review XX        
Field visits and data collection   XX      
Submit the draft report with all relevant annexures and lists     XX    
Share the findings with BHW WG and selected guests       XX  
Final reporting         XX

Management and Logistics

  • The consultant/ firm will report to the Chief Coordinator/Project Advisor of BHW;
  • The project will provide project documents;
  • The consultant/ firm will be responsible for organising meetings, follow up meetings, the workshops and all logistics;
  • The consultant/ firm is expected to use their own computers;
  • The consultant/ firm will bear other cost for transportation, accommodation, printing, and photocopy.

Key competency of the researcher

The researcher should have the following competencies:

  • Having previous experience to conduct relevant research;
  • Good report writing skill, specifically on the similar types of content development;
  • Working in tight schedule and maintaining deadline for deliverables;
  • Understanding on health issues and civil society movement.

Payment: 

The consultant/firm will be paid an agreed amount including applicable tax & vat as per government rule for the total assigned service. Full payment will be made upon completion of the assignment. The payment mode would be in three (03) instalments for the entire assignment against invoices issued by the Consultant:

  • First instalment is 20% after submitting the inception plan;
  •  30% of the payment will be made after submission of the draft report.
  • And remaining 50% will be paid upon satisfactory submission and acceptance of the final report;
  • consultant/firm has to submit the TIN certificate;
  • BHW will not be liable for any bank charges arising from incorrect bank details being provided to us.

Please send the proposal, budget and CVs of consultant on or before 27 September, 2020 at bhw@bracu.ac.bd