Term of Reference (ToR)
Consultancy Firm for Annual Assessment of ASTHA

A. Background

Swisscontact is the business-oriented independent foundation for international development cooperation. Headquartered in Zurich, Switzerland the organisation is represented in 33 countries with over 1,100 employees, promoting - since 1959 - economic, social and environmental development. The focus of its systemic interventions in the private sector is the strengthening of local and global value chains. Swisscontact concentrates on four core areas of private sector promotion: Skills Development; Enterprise Development; Inclusive Finance and Climate-Smart Economy.

The project “Achieving Sustainability Towards Healthcare Access” (ASTHA); formerly known as TARSAN) was introduced in 2011 to address the gap in healthcare workforce of Bangladesh. Jointly funded by Novartis and Swisscontact, the project aims to improve access to quality healthcare services at rural level through development of skilled Community Paramedics (CPs). Certified by the Bangladesh Nursing and Midwifery Council (BNMC), the Community Paramedic course allows students to gain professional skills in providing primary curative healthcare services, focusing on maternal and child health and family planning.
ASTHA facilitates the development of these frontline health workers who connect the locals to proper health services. Phase II is the latest phase of ASTHA which is a four-year project (2019 – 2022) designed to facilitate the improvement and retention of Community Paramedic services in rural Bangladesh. ASHTA focuses on four major intervention areas:

Intervention Area 1: Strengthen Community Paramedic (CP) Programme and capacity of Community Paramedic Training Institutes (CPTIs)
Intervention Area 2: Enhance the capacity and service provision of CPs
Intervention Area 3: Sensitise public and private scale agents
Intervention Area 4: Mobilise communities to create awareness:

• to change their healthcare service seeking behaviour
• to promote CP-based healthcare services

ASTHA is seeking to appoint a qualified consultancy firm to evaluate the effectiveness of the project interventions during the year 2020.

B. Objective

The overall objective of the assignment is to assess the performance of the project interventions in the 7 project districts: Nilphamari, Patukhali, Sunamganj, Sylhet, Rangpur, Lalmonirhat and Barguna.

Some of the more specific objectives of the assignment will be, but not limited to are:

• Understand the current challenges caused due to the COVID-19 crisis and persistent difficulties faced by CPs. Understand steps taken by CPs to overcome these challenges.
• Evaluate any changes in perception on CP services after emergence of the pandemic.
• Gather information on the level of quality/confidence/capability of CPs and their improvements due to project interventions.
• Evaluate the extent to which the project has established Community Paramedics in project locations.
• Assess number of patients who have taken services from CPs during the year.
• Asses the perception of patients and communities regarding CP services and their level of satisfaction, particularly during the ongoing crisis.
• Evaluate the level of awareness that CPs have created about COVID-19 among their patients.
• Assess the contributions made by the project in awareness raising/changing the behaviour of the rural communities in seeking proper healthcare.
• Assess CPs’ income trends/income categories/fees/patient referral trends/referral destinations etc. in project locations.

C. Methodology, Sample Size & Activities

I. Methodology for the Assessment

The study will primarily be conducted with a sample of the existing CPs under the project network and community members living within the vicinity of those CPs. Some in-depth interviews of local government officials in the health sector must also be conducted to evaluate CPs engagements with the ongoing government efforts. The detailed methodology for this assessment is to be developed by the consultancy firm.

II. Study Population:

The study population will be consisted of:

• Community Paramedics
• Patients of Community Paramedics
• Local government officials (e.g. Civil Surgeon, Upazila Health and Family Planning Officer)

III. Sample Size

The specific sample size of the study is also to be proposed by the consultancy firm which ensures statistical significance as well as cost efficiency. Currently there are around 551 practicing CPs in ASTHA’s project locations.

 IV. Tasks of Consultant  

The suggested, but not limited to, specific tasks of the firm are:

• Develop study design to meet the assessment objectives
• Prepare assessment tools and database format
• Arrange and train enumerators for the study
• Conduct formal assessments using qualitative and quantitative surveys
• Transcription of recordings (if required)
• Data entry
• Analysis of data
• Preparation of draft report for feedback
• Preparation of final report

V. Role of Swisscontact - ASTHA

• Assist in study planning activities and provide technical assistance (as required)
• Provide list of the CPs and their locations
• Provide support in enumerator and supervisor training (as required)
• Bear all costs (as per approved budget)
• Provide overall guidance

D. Deliverables and Timeline

The outputs of this assignment will be used to prepare the Annual Report of the project. The firm is therefore, required to submit deliverables within strict deadlines. The tentative timeline of the assignment is provided below.

E. Required Documents

All bidding consultants/firms are required to submit the following:

• A technical proposal (Maximum 20 pages) showing understanding of the assignment, proposed methodology, assessment tools, time-line (activity plan), key staff profiles, roles and individual time to be spent in the assignment;
• A separate financial proposal setting out a detailed budget for the assignment;
• A summary of relevant services (particularly healthcare surveys, if any) provided during the last 3 years;
• Submission of an organizational profile, with the CVs of key personnel who will be involved in the assignment;
• A list of the existing clientele of the organization;
• It is mandatory for the bidding organisations to submit documentary evidence demonstrating their legal, taxation and financial status. This includes:
• A certificate of incorporation (for individual companies, a trade license);
• NGO bureau registration (if applicable);
• An organizational organogram of key personnel, inclusive of the names of such personnel;
• Tax identification number (TIN);
• VAT registration number;
• Proof of a segregated account (providing the name and address of such account);
• A signed statement testifying that all information contained within the proposal is correct and true.

F. Selection criteria

While the exact set of criteria will usually vary based on the nature of the assignment, the following criteria are generally applicable for evaluation of the potential consultant/firm:

G. Submission Details

The potential consultancy firm is to submit a technical proposal and a financial proposal with other necessary documents by 28th October 2020 before 05:00 pm to bd.procurement@swisscontact.org with the subject line: “Consultant for Annual Assessment of ASTHA ” .

 For more information please e-mail: samaun.bhuiyan@swisscontact.org  N.B.: Swisscontact reserves the right to reject or cancel any offer