Consultant (Nasarawa State Primary Health Care Management) at Development Activities International (DAI) Nigeria

DAI has a history of workin Nigeria going back to the 1970s, implementing dozens of major projects for clients including the U.K. Department for International Development, the U.S. Agency for International Development, the European Union, and the Chevron-funded Partnership Initiatives for the Niger Delta. Ongoing projects in Nigeria include conducting water, sanitation, and hygiene initiatives; empowering women to serve as nurses and midwives in Northern Nigeria; promoting more accountable, responsive, and capable state and federal governments, while building the government's capacity to develop pro-poor public policy; and boosting incomes through investment and market systems in the Niger Delta.

Applications are invited for:

Title: Invitation to Submit Expression of Interest for Nasarawa State PHC Management System

Location: Nassarawa
Assignment Title: Nasarawa State Primary Health Care Management System Capacity Diagnostic
Language of Notice: English
Assignment Country: NG - Nigeria
Funding Sources: DAI-TA Hub / BMGF
Sub-award type: Organization / Firm

Assignment Description
DAI is the interim manager of the TA Hub and is funded by the Bill and Melinda Gates Foundation (BMGF) to establish and incubate the TA Hub. DAI functions as a start-up incubator for the TA Hub and oversees the early technical assistance deployments implemented through the TA Hub.

The Technical Assistance Hub (TA Hub) provides comprehensive, cohesive technical assistance and institutional strengthening support to State Governments, using a tailored approach to promote sustainable PHC systems strengthening and enhanced PHC service delivery. It also works to meet donor needs for grant efficiency, effectiveness and local participation. The TA Hub works with States and funders to define issues, identify solutions, and the skills/expertise needed to help strengthen the effectiveness, efficiency, and quality of PHC services and then manage the selection and deployment of technical assistance (TA).

Nasarawa is a state in the North Central region of Nigeria with a projected population of 2,523,400 people (2016). The state has 13 Local Government Areas (LGAs) and is administratively divided into 3 Senatorial districts with 195 political wards. Nasarawa state has1040 health facilities in total including 728 PHCs distributed across the 195 political wards. Like Nigeria's poor health care indices, the overall health indices in Nasarawa state is suboptimal with the state being unable to fully provide the level of services required to meet the health needs of its growing population[1]. Several reasons have been attributed to this including insufficient financing, inadequate and inequitable access, weak public financial management system and supply chain management, limited human resources in terms of availability and capacities, program cohesion and resource accountability. Specifically, underlying factors such as paucity of skilled human resource for health, skewed distribution of health care workers leading to low access and quality of services especially in rural areas, defective and poorly coordinated preventive and health promotional programs have been indicated to contribute significantly to the suboptimal state of the Nasarawa healthcare system. Despite the relatively good progress made by Nasarawa state towards improving its health indices as reflected through health status indicators such as, percentage of skilled birth attendance and antenatal care coverage, which are above the National average, other indicators such as Under-five and infant mortality rates remain higher than the National average3.

In 2009, Nasarawa State began implementation of the PHCUOR policy; leading to the establishment of its SPHCDA, all PHC staff being transferred to SPHCDA, and the State legislature has passing a law backing the agency. This paved the way for the appropriate legislation and coordination needed to manage health care facilities across the state. In 2017, the Nasarawa State Government was the recipient of a $500,000 BMGF grant in support of primary health care across the 13 local government areas and 18 development areas of the state. With the primary objective to support the improvement of structures and systems of governance and leadership, performance management, and financing of Primary Health Care for the benefits of the people of Nasarawa state. Ongoing donor interventions on PHC Strengthening and Service Delivery provides this deployment the opportunity to build on the body of knowledge in the area and learn from past successes.

To enable expansion of PHC Management Strengthening support to Nasarawa State, the state is seeking technical assistance to conduct a comprehensive diagnostic assessment of its PHC Management System Capacity. This diagnostic assessment will contribute to more sustainable, high-quality service delivery in the state by identifying specific gaps in priority areas and providing options for a strategic plan to address gaps identified. Building on previous assessments conducted in the state, the assessment will entail providing technical support to Nasarawa state in carrying out participatory PHC management capacity diagnostic to establish system gaps and TA needs, which will in turn inform the development of an evidenced-based PHC management strengthening plan (PMSP).

Nasarawa State, like other states in the country, is also dealing with the COVID-19 pandemic, which has increased the burden on the lean human and financial resources. In addition to assessing key components of the PHC Management System Capacity, this diagnostic will analyze the impact of the pandemic on Nasarawa State PHC management systems, looking at the effects on relevant aspects of the health management system.

Objectives

• The core objective of this assignment is to diagnose the capacity gaps in PHC Management Systems Capacity towards strengthening PHC service delivery and improving access to quality services for residents of Nasarawa State.
• The assignment is targeted at complementing the states' efforts by providing Technical Assistance to the State to conduct a PHC Management Systems Capacity diagnostic that will identify existing gaps in the PHC Management System Capacity and highlight what interventions are required and make recommendations on how the state can prioritize and implement these interventions.
• The key output of the assignment is a costed State PHC Management Capacity Strengthening Plan which will serve as a roadmap for the State to address prioritized gaps.

The technical assistance would support the following objectives:

• To conduct a PHC Management System Capacity Diagnostic.
• To identify gaps in PHC Management System Capacity.
• To assess the impact of the COVID-19 pandemic on the state’s PHC system; and
• To develop a PHC Management Capacity Strengthening Plan based on the results of the diagnostic outlining priority interventions that the State can embark upon to strengthen its PHC Management System Capacity and improve service delivery.

Primary deliverables of this investment will achieve or significantly contribute to:

• Provide a deeper understanding of the exact gaps in the Nasarawa state PHC Management System Capacity.
• Provide evidence to support state prioritization and planning of interventions to address identified gaps.
• Develop a PHC Management Capacity Strengthening Plan outlining priority interventions that the State can embark upon to strengthen its PHC Management System Capacity and improve service delivery.

Considering the current reality, the diagnostic will include an assessment of the impact of COVID- 19 crisis on the Nasarawa State PHC system, looking at service uptake / provision, availability of commodities / supply chain, and other critical PHC pillars, considering the disruptions caused by the pandemic. A deeper understanding of the exact gaps in the PHC system will inform state prioritization and planning.

Three key outputs are expected from the planning process. These are:

• PHC Management Capacity Assessment Report
• PHC Management Capacity Strengthening Plan, and
• COVID -19 Impact Assessment Report.

The PHC diagnostic study will be conducted over 60 days, at a maximum funding of $180,000 (One Hundred and Eighty Thousand Dollars Only).

Qualification Criteria
The TA Hub now invites eligible firms to indicate their interest in providing the services. Please note the following conditions:

• The firm is organized under the laws of the Federal Republic of Nigeria; OR
• The organization is conducting business as an "ongoing concern" (functioning business entity for foreseeable future) Nigeria: and either a or b Below:
  • The organization is managed by a governing body, the majority of whom are citizens or residents of the country; OR
  • The organization 's employment of citizens or residents of the country in more than half of its permanent full-time positions and half its principal management positions.

Sub-awards may not be awarded to individuals, only entities or organizations. The Sub awardee can demonstrate, through a due diligence process, that it has the necessary internal controls and organizational maturity to manage the scope, finances, and compliance aspects of a potential award.

Private Sector firms, may apply (in additional to NGOs), but will only be awarded to private sector firms when:

• A private sector firm is clearly best placed to carry out an activity.
• Where they have the capacity to implement or have already received TA and are now in a position to implement.
• Where they forgo any generation of profit.
• They have been vetted / assessed by TAConnect as having the necessary financial management systems and reputational assets to be held accountable for results.
• There is a clear sustainability plan in the form of continued feasibility and the wide adoption of the technology or service delivery approach to promote adoption and change.
• Awards to the private sector will likely be performance-based, with amounts payable in tranches against the achievement of clear deliverables. Deliverables are different than milestones, in that deliverables are clear outputs or outcomes, whereas milestones are achievements of progress towards an end goal.

[1],2,3 USAID (2018). Analyzing fiscal space for Health in Nasarawa State. Available at: https://www.slideshare.net/HFGProject/analyzing-fiscal-space-for-health-in-nasarawa-state-nigeria#:~:text=The%20state%20has%20a%20total,health%20status%20of%20its%20citizens.

Application Closing Date
23rd November, 2020 at 5pm (WAT)

How to Apply
Interested and qualified candidates should submit a Concept Note describing how your organization will carry out this work, along with your organizational profile with the following information:

• Evidence that your organization is qualified to undertake this work.
• Organizational background, with details on the technical expertise and experience available within the organization.
• Details of your organization's core business and managerial capabilities.
• Qualifications of your key staff.

All submissions should be electronic through the TA Hub at: [email protected] Please note that the total size of all attachments should be less than 5MB. Concept notes should not exceed 5 pages, must be single-spaced,12-point font, with one-inch margins (all margins).

Important Information and Notice

• Two organizations may submit a joint concept note to enhance their qualifications and areas of expertise.
• The TA Hub may ask for additional information and verify any information submitted.
• Shortlisted organizations will be invited to respond to a Request for Proposals. Awards are subject to a due diligence process and will be made in accordance with DAI's Procurement Policies and Procedures.