Consultant - Health Hazard Vulnerability Analysis (HVA)

1.       Background

The role of communities in health related emergencies depend upon their level of training, capacities, health service delivery, and the health-system support at community level. Medical related emergencies have a direct and indirect impact on the health of a population, resulting in physical trauma, acute disease, and emotional trauma along with an increase in the morbidity and mortality associated with chronic diseases. Health related emergencies mostly affect the poorest and vulnerable communities due to their low socio-economic status and poor living conditions. In addition to large-scale medical emregencies, the local level emergencies such as epidemics, road accidents, injuries affect rural and urban communities regularly in Pakistan. These medical emergencies, significantly threaten the health of communities including loss of life, injury, illness, and disability, and destroy the health facilities and disrupt basic essential services further increasing morbidity and mortality as well as putting the health providers at risk. World Health Organization-Pakistan is also striving for community-level capacity development through information, education, and risk communication for households and communities at risk to promote healthy behaviors to reduce risks and prepare them as first line responders to deal with medical emergencies. The purpose of community and local level medical risk reduction program by WHO in Pakistan is to ensure community-based health workers and community volunteers can effectively participate in community-level health risk reduction efforts by playing an active role in village level health committees and also responding to community health needs before, during and after a health related emergency. In this context, International Medical Corps-Pakistan requires services of a firm/individual consultant to conduct a health related hazard vulnerability analysis (HVA) and risk assessment to identify hazards or risks that are most likely to have an impact on a healthcare facility and the health of surrounding communities under its project “Builfing Resilience and Preparedness of vulnerable communities through practicing Healthy Behaviours and Providing Basic Life Saving Skills’ Trainings” for Afghan refugees living in target refugee villages of Khyber Pakhtunkhwa province.

Objectives of the assessment.

The overall objective of the assessment is to conduct a health hazard vulnerability analysis (HVA) to identify potenitial health related risks, and the capacity assessment of target Afghan refugee communities in three districts of Khyber Pakhtunkhwa province to cope up with these potential health related threats, measure the probability of those health related threats, and guide to develop the village level health paredness plans to deal with medical emergencies as a Firstline Responders. 

Specific objectives are:

1)      Identify health-related vulnerabilities  and the direct and indirect effect of these hazards may have on the community,

2)      Assess the current health system capacity of target communities to respond to health related emergencies i.e. epidemics, accidents/casualties/infrastructure damage of health facilities, and disease outbreaks, etc.

3)      Identify simple, cost-effective and efficient interventions to strengthen capacities of healthcare system and the coping mechanisms of target communities to enhance their knowledge, improve skills, and provide resources (medical equipment and supplies) to be the first-line responders for health related emergencies.

4)      Develop village-level health preparedness plans for each target village with its warning systems including information on how to respond to health related emergencies and coordination with relevant local health related stakeholders for a medical emergency response in their respective villages to reduce emergency related morbidity and mortality.

2.       Methodology and Tools:

The consultant will design assessment methodology, tools, and sample size of the questionnaire for individuals, key informant interviews, and or FGDs for data collection in the field from various stakeholders. A mixed-method approach will be recommended when collecting the data in the field. This approach uses both quantitative via administering the structured assessment tool and qualitative methods through Key Informant Interviews (KII) and Focus Group Discussions (FGD).

The recommended methods for data collection are:

A mixed-method study (cross-sectional study and followed by a qualitative study).  

• Secondary data and desk review of reports and documents from various sources i.e. Government, UN, NGOs, and any other agency.
• Primary data collection in the field through questionnaires from key informant interviews, FGDs, transect walks, and personal observations in target communities.

The assessment will be conducted in the province of Khyber Pakhtunkhwa covering the following three districts in 7 refugee villages with the community members and other relevant stakeholders.

Districts

 Locations (Afghan Refugees Villages)

Peshawar

Mera Kachori

Badaber

Shamshatoo

Lower Dir

 Toor 

Taimer

Chakdara

Haripur

Panian (I &II)

1.       Scope of Work

Using a combination of qualitative and quantitative research techniques and analysis of primary and secondary information/reports, the consultant/ firm will:

Key responsibilities:

• Draft assessment plan in consultation with in-country health technical specialists and Health Technical Unit.
• Design tools, including interview guides, focus group discussion guides, data analysis matrix, and other data collection & analysis tools as needed for assessment and ensure International Medical Corps Pakistan and International Medical Corps Headquarters technical review of the plan and tools.

·         Identify/take an on-board team of data collectors (male/female) and lead training for data collectors in target refugee villages.

• Oversee data collectors’ work on assessment, focus group discussions, and key informant interviews in the field, as well as the other data collection activities.
• Conduct key informant interviews in the field and with key stakeholders including community elders, UNHCR and Commissionerate for Afghan Refugees (CAR).            
• Lead and oversee the data analysis.
• Design tools and develop village level health preparedness plans for each target Refugee Village.
• Present initial findings to the in-country health team before submission of the final report.
•  Share the first draft with International Medical Corps Pakistan and the International Medical Corps headquarters’ health technical unit, address recommendations, and finalize the report.

2.       Selection Process and Criteria:

The potential consultant/firm will be offered a service agreement. He/she will submit a detailed technical and financial proposal. The proposal will devise the technical strategy and all costs.  The proposal should include:

• Cover letter addressing the requirements stated
• Detailed CVs of expert(s)
• Description of methodology to address the criteria and content of the Terms of Reference and may detail what additional improvements / best practices the consultant can introduce while collecting and computing the data
• Samples of previous work including tools used and reports produced
• Three references (names, email, and phone contacts) from previous clients where similar work has been conducted

1.       Deliverables

 The required outputs of this consultancy will be as follows: 

·         An assessment plan outlining the approach/methodology and execution program/timetable. This plan shall be submitted for review and approval by the International Medical Corps 10 days after the signing of the contract before commencement of the work.

·         Data collection tools shall be submitted within 5 days after acceptance of the methodology for review and approval by the International Medical Corps.

·         Draft assessment report, which is submitted within 7 days after completion of the fieldwork and shall be accompanied with the raw data as collected through the data collection tools.

·         Presentation of the key findings should be included in the draft report.

·         The final assessment report shall be submitted within 10 days after the inputs provided by the International Medical Corps staff. 

·         Draft village level health preparedness plans for 7 target refugee villages.

2.       Report

8.1  Outline of the Report

The assessment report should contain the different elements mentioned below. All parts should be clearly distinguished from each other and of sufficient quality. The reports submitted by the consultant shall live up to the quality standards provided by International Medical Corps.

·         Cover page

·         Table of contents

·         Acronyms

·         An executive summary that can be used as a document in its own right. It should include the major findings of the assessment conducted and summaries of conclusions and recommendations.

·         The objectives of the assessment.

·         The main assessment questions and derived sub-questions.

·         A justification of the methods and techniques used (including relevant underlying values and assumptions, theories) with a justification of the selections made (of persons interviewed, UCs visited).

·         A presentation of the findings and the analysis thereof (including unexpected, relevant findings). All research questions should be addressed, paying attention to gender issues.

·         Conclusions, which will analyze the various research questions. Conclusions will have to be derived from findings and analysis thereof.

·         Recommendations should be practical and if necessary be divided up for various actors or stakeholders as well as sectoral and include guidelines of how they can be implemented.

Report annexes.

 The reporting style should be clear and accessible. References to sources used, such as interviews, literature, reports, must be given.

Confidentiality of information: all documents and data collected will be treated as confidential and used solely to facilitate analysis. Interviewees will not be quoted in the reports without their permission. All applicable COVID-19 prevention measures will adhere while carrying out this survey to reduce the risk of transmission for staff and participants. Physical distancing, mask-wearing, and hand hygiene should be prioritized for all involved in the survey.

9.1  Overall Consultancy Period

The entire period of this consultancy will be eight weeks that will include preparation,  designing of the tools, field testing and reviewing of the tools, actual fieldwork, data analysis, dissemination of the key findings to stakeholders, and reviewing of the final report. The time for completing the assignment and provision of the final report is within 8 weeks of the signing of the contract agreement expected to be starting from May 1, 2021, till June 30, 2021. The consultant will provide a work plan detailing all activities from initiation to the submission of final deliverables.

9.2.   Submission/Comments Timing

All the required documents and reports in their draft form and final versions shall be submitted to Medical Coordinator within the specified timing in section 8 (deliverables) of this ToR. It is pertinent to mention that both; the Medical Coordinator and MEAL Manager commit to giving written feedback to each of the submitted documents within 5 working days of receipt. 

9.3    Narrative Reporting

For this award, a final narrative report is due by June 30, 2021.

9.4   Financial Reporting

The final financial report is due by June 30, 2021. The final report should be a simple report showing how funds were utilized per general categories. The team does not need to provide details per budget lines.

3.       Administrative Information

10.1           Tax Arrangements

International Medical Corps will deduct withholding tax from the consultancy fees, which will conform with the prevailing government rates in Pakistan. 

4.       Supervision

The overall supervisor of this assignment will be the Medical Coordinator of International Medical Corps Pakistan.

5.       Qualifications

Well-recognized and reputable research, consultancy firm/company or individual consultants having documented experience in health related emergencies and similar assignments in Pakistan are eligible to submit their proposals.

Code of Conduct & Ethics

·         It is our shared responsibility and obligation to prevent matters involving Sexual Exploitation & Abuse, Trafficking in Persons, Child Safeguarding and any suggested violation to our Code of Conduct, which may involve Conflicts of Interest, Fraud, Corruption or Harassment.  If you see, hear or are made aware of any suggested activities then you have an obligation to report.

General Conditions

• No contract may commence unless the contract is signed by both parties.
• The team members of the consultancy firms are not entitled to payment of overtime. All remuneration must be within the contract agreement.
• Accommodation and meals will be covered by the consulting firm/company/individuals. Therefore, the price component must contain an overall quotation. However, a detailed budget is required to show the actual breakup.
• The consulting firm/individual should provide its team with relevant IT equipment and other office supplies related directly to the task.
• International Medical Corps will provide facilitation such as addresses/contact details, meetings with the community, etc., for the movement of the teams in the field and geographic areas.
• The travel to and from and within the field will be arranged by the International Medical Corps.
• Final payment to the consulting firm/individuals will be dependent on the completion of deliverables (to be specified in the contract) as well as handover notes and relevant data.

6.       Validity of Proposal

The last date for submission of proposals is May 10, 2021. Proposals will be valid for 30 days. International Medical Corps reserves the right to reject any or all proposals received in response to this RFP and is in no way bound to accept any proposal. The client additionally reserves the right to negotiate the substance of the finalists’ proposals, as well as the option of accepting partial components of a proposal if appropriate.

7.       Human Subject Protection Issues

The consultant must follow the confidentiality, privacy, and sensitivity of the International Medical Corps and all ethical considerations including national and international protocols during the survey. 

8.       Intellectual Property Rights

All outputs under the assignment shall be the sole property of the International Medical Corps. The Consultants shall not exercise any rights on all the outputs and cannot share the same with any outsiders without the prior consent of the International Medical Corps.