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Scopes of work
HIV costing, cost-effective studies, and financing systems
LINKAGES Thailand/FHI 360
FHI 360 Brief Background
FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in health, education, nutrition, environment, economic development, civil society, gender, youth, research and technology, creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 70 countries and all U.S. states and territories.
Funded by the U.S. Agency for International Development (USAID) and managed by FHI 360, the Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) project in Thailand focuses on interventions to reduce HIV transmission among key populations, predominantly among men who have sex with men (MSM) and transgenders (TG). Most interventions are implemented through community-based organizations (CBOs) and include reach-recruit-test-treat-prevent-retain (RRTTPR) interventions such as peer-driven outreach, use of social media, HIV testing in community clinic settings, pre-exposure prophylaxis (PrEP) provision, and increasingly, HIV treatment in community-based clinic settings.
Although the Government of Thailand supports an overwhelming majority of its HIV response, most of the funding for interventions for key populations through local NGOs is currently supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) and the Global Fund for AIDS, TB, and Malaria. There is increasing recognition that the Government of Thailand needs to finance local NGOs to support interventions with key populations in the near future. This has started on a limited basis by the National Health Security Office (NHSO) through reimbursement to local NGOs on a per head basis, e.g. per person HIV tested.
While there is a significant amount of performance data on RRTTPR interventions from NGOs, there is a pronounced gap in understanding the routine costs of community-based HIV services as well as their cost-effectiveness in the national response. There are numerous recent innovations in RRTTPR interventions in Thailand where their costs and cost-effectiveness are unknown. This includes the following interventions: enhanced peer mobilization, both by outreach workers doing traditional site-based outreach as well as more recent on-line outreach in virtual spaces to promote HIV testing; pre-exposure prophylaxis (PrEP) promotion and uptake through NGOs; uptake of ARV treatment supported by case management approaches by CBOs; and differentiated care approaches whereby ARV treatment follow-up by clinics and NGOs are differentiated depending on client characteristics and recent ARV treatment adherence.
Scopes of Work
To help fill this gap, LINKAGES Thailand/FHI 360 is seeking a consultant or group of consultants to implement the following phases of this work:
Scope of work 1:
Phase 1 - Develop consensus among stakeholders of costing and cost-effectiveness studies to be supported by LINKAGES – Based on global evidence on costing and cost-effectiveness of interventions targeting key populations and gaps in Thailand, the consultant(s) will meet with stakeholders in Thailand to develop a list of planned cost analyses and cost-effectiveness studies for Thailand to be supported by the USAID LINKAGES Project. Stakeholders include the Ministry of Public Health AIDS Division and the National Health Security Office (NHSO) and other divisions to be identified, USAID, US CDC, local NGO implementing organizations, and local health economists. The consultants will present and summarize global examples to facilitate the consensus-building process in Thailand. Based and discuss with FHI 360/LINKAGES to develop appropriate methods and framework to allocate operational costs to capture the specific per unit costs of the LINKAGES project.
Design routine cost analysis framework and components for local NGOs serving key populations - Using global evidence and standards in costing key population interventions, the consultant(s) will work with FHI 360/LINKAGES and local NGO partners to advise on appropriate methods to allocate operational costs to capture the specific per unit costs of RTTPR interventions on an on-going basis. Operational costs of NGOs include costs directly attributable to specific interventions but also indirect costs that need to be allocated to each intervention category. Interventions are in the process of being refined and honed over time with the goal of reducing unit costs, and so the costing methods will need to take into consideration these refinements and track if interventions are reducing unit costs. FHI 360/LINKAGES has developed a dashboard that will track RRTTPR performance indicators for each NGO partner over time. The consultant(s) will work closely with FHI 360/LINKAGES on how these unit cost analyses can be integrated into these performance dashboards.
Phase 2 - Specific cost studies and implement them in collaboration with FHI 360/LINKAGES and other partners – Based on the above consensus-building process on costings and cost-effectiveness analyses, phase 2 will consist of the implementation of these studies. The following are currently envisioned but may change depending on the consensus-building process with stakeholders:
Scope of work 2:
Develop systems for the financing of community-based organizations – FHI 360/LINKAGES is seeking consultant(s) to provide technical assistance to governmental entities, e.g. ministry of health, provincial health services, on appropriate systems and processes to procure HIV services from and manage grant-type mechanisms with community-based organizations. Systems may include the development of guiding principles and operational procedures for tendering services, e.g. requests for proposals (RFPs). These principals and procedures will underscore the importance of community-level planning that includes both government and non-government organizations; prioritization of interventions that stresses community involvement and value for money; and equitable and fair processes for determining the distribution of funding across different key populations. Areas of technical assistance may include pre-grant planning (government and community planning bodies, budgetary allotment), procurement processes (equitable and competitive procedures for selecting partners), and grants management (grant and payment schemes, monitoring and evaluation processes).
The Thai MOPH may also be forming parastatal organizations in the near future to manage HIV funding for local NGOs. Consultant(s) will work with LINKAGES to assist the Thai MOPH in understanding global examples of successful parastatal organizations and to advise on appropriate policies and procedures of such an organization in Thailand.
Scopes of work 1: Consultants will have successfully conducted similar unit cost analyses and cost-effectiveness studies according to global standards in other country settings and can demonstrate evidence of this work.
Scope of work 2: Consultants will have successfully worked with or advised on the formation of parastatal organizations that serve MOPHs and/or with ministries of health, provincial health services, health departments, etc. to develop or manage procedures and processes that finance community-based organizations.
Period of Performance
The estimated Period of Performance is November 2017 – October 2018, but these dates will be negotiated with the chosen consultants depending on the actual scope of work.
Instructions to Apply
Consultants or groups of consultants should submit a letter of interest outlining possible approaches to the scope(s) of work and relevant expertise and experience (2 pages maximum), CVs, and soonest dates of availability for initial planning and design consultations in Bangkok, Thailand. Consultants may apply for any or all scopes of work but this should be made clear in the letter of interest.
Instruction to Applicants and Submission Requirements
FHI 360 is requesting interested applicants, group of applicants affiliated with an institution to provide the following documents specified below. Please submit all requirements by e-mail to email@example.com by 5.00 PM Bangkok time on October 20, 2017. Applications received after this date and time will not be considered.
Up-to-date CV(s) for all key areas.
Contact : firstname.lastname@example.org/02 263 5274
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Phone : 02-3144112-3, 02-3183959
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