TERMS OF REFERENCE

INDIVIDUAL CONTRACT
FOR

Assignment Title : Development of Job aid (flipcharts) for case workers
Project Name : BGD Strengthening case management of HIV positive PWID
Program : HIV/AIDS
Agency : Save the Children in Bangladesh
Number of days : 20 (Twenty) days, starting from July 01, 2019 to August 20, 2019

GENERAL BACKGROUND

In response to concerns about coverage, quality and efficiency, many global and national guidelines now recommend the use of differentiated service delivery (DSD) model. This is a client-centered approach that simplifies and adapts HIV services across the cascade to reflect the preferences and expectations of various groups of people living with HIV while reducing unnecessary burdens on the health system. In all three pillars of continuum of care, namely a) Reach; b) Testing c) Treatment & Adherence, DSD model can be applied. Globally, Save the Children has started DSD in few countries.
For reach, technology enhanced outreach app applied in Myanmar; for testing Philippine introduced three types of approach such as HIV testing by lay providers/ motivators- CBS/CBT, ICT utilization- #safely, and Self-Testing. For Treatment & Adherence, in Zambia, P-Track has been introduced for lost to follow up clients (LTFU) for ART.

Ensuring chronic HIV care to PWID living with HIV is one of the important initiatives taken by Save the Children to response in Dhaka HIV epidemic. In April 2017, as part of the initiatives, Save the Children has converted three drop in centers (DIC) in C-DIC through integration of HTS, ART, point of care CD4 testing, OST and HIV-TB coinfection management with other harm reduction services. However, management of ART including adherence and retention was a big challenge. For that reason, Dhaka based PWID DICs started ‘case management’ through ‘Case Workers’. It is planned that 80% of case workers themselves should either be HIV positive or a family member of an HIV positive PWID
which will give them a better understanding of the needs of an HIV positive PWID. Case workers under C-DIC are reportable to ‘Counsellor’ and case workers under regular DICs are administratively reportable to ‘Field Monitor’ and technically to ‘Counsellor’ of respective C-DIC.

To address the effectiveness of the case worker model and strengthen the approach, Save the Children submitted a proposal to WHO Bangladesh and was awarded new project “Strengthening case management of HIV positive PWID” started from 1 November 2018 to 31 October 2019. This is an opportunity to advance community system development using the Global Fund program platform. The main purpose of the project is to reduce HIV related morbidity and mortality among PWID living with HIV and AIDS at the selected 14 PWID drop in centers in Dhaka through strengthening case management by the case workers those are from community.

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