The development of the national strategy for the implementation of an PCI program within the Ministry of Health and Population in CAR At French Red Cross

CONSULTANCY TOR
PROVISIONS OF INTELLECTUAL SERVICES FOR
THE DEVELOPMENT OF THE NATIONAL STRATEGY FOR THE Establishment OF A PCI (Prevention and Control of Infections) program within the Ministry of Health and Population in CAR

1. General

Project / Service / Department

Global Fund Program/CF350 C19RM

Purpose of the mission: Development of the national strategy for implementing a PCI Program within the MSP with the development of a PCI procedures manual and a PCI training manual

Mission location: Bangui, Central African Republic

Responsible for the mission At the MSP: Director of the organization of care and management of the university hospital space/National PCI focal point

At the FIU: Head of the C19RM/RSS Program

Desired start date 05/15/2024

Desired end date 09/13/2024

Date of delivery of deliverables 09/19/2024

Duration of the mission 90 days

2. Introduction

Many inadequate medical practices and healthcare risks are becoming major challenges for the safety of healthcare personnel and patients. They contribute significantly to the burden of harm from unsafe care. The threats represented by epidemics, pandemics and antimicrobial resistance increasingly appear to be universal problems and are today recognized as an absolute priority for health action.

Healthcare-associated infections (HAIs) affect hundreds of millions of patients worldwide each year. These infections are the cause of serious pathologies, prolonged length of stay in healthcare establishments, long-term disabilities, significant costs for patients and their families, and high additional financial burdens for healthcare systems. health, and worse, the tragic loss of life. HAIs are a cross-cutting problem, largely unknown or underestimated, that no healthcare establishment or country can claim to have solved.

The WHO mentions in its latest global report on infection control that in acute treatment hospitals, out of 100 patients, 7 in high-income countries and 15 in low- and middle-income countries contract at least one nosocomial infection. during their hospitalization. According to the WHO, Global data estimates that 1.4 million people are affected by nosocomial infections each year and that in low- and middle-income countries, 1 in 10 patients acquire an infection while receiving care, up to 90% of health workers do not wash their hands in some health facilities. Effective IPC measures are proven to prevent up to 70% of healthcare-associated infections.

The baseline assessment of infection prevention and control (IPC), conducted between August and December 2020 in 1106 facilities across 22 countries by the International Rescue Committee (IRC), revealed key gaps and areas requiring further attention. improvement in PCI. This includes a lack of human and material resources, limited access to IPC training, inadequate institutional policies/guidelines, as well as poor health infrastructure.

The Central African Republic is a country that extends over 623,000 km2. It is completely landlocked and is more than 1000 km from the ports of Douala in Cameroon and Pointe-Noire in Congo. It is limited to the north by Chad, to the east by Sudan and South Sudan, to the west by Cameroon, to the south by the Democratic Republic of Congo and the Republic of Congo to the south.

According to projection data from the General Population and Housing Census (RGPH) in 2003, the Central African population is estimated in 2023 at 6,399,458 inhabitants. This population is made up of 1,107,106 children aged 0 to 59 months, or 17.3%, and 1,574,266 women of childbearing age, or 24.6%. Life expectancy at birth is 53.3 years, and there is a very high morbidity and mortality rate with a low Universal Health Coverage index (WHO 2022 annual report) according to the same report, Viral hepatitis constitutes a real threat to the Central African populations. The 5 main viruses responsible for viral hepatitis are found in the Central African Republic with high prevalences, for HBsAg, for Anti-HCV, for Anti-HVD, 25.8% for Anti-HEV. Prevention, screening, treatment and care services for viral hepatitis are not sufficiently integrated into the country’s health establishments. Screening is mainly carried out in the two large reference laboratories in the capital Bangui, in the laboratories of the University Hospitals and the CNRISTTAR as well as in the laboratory of the Blood Transfusion Center and in the health facilities supported by the MSF in Bangui, Bangassou, Kabo , Batangafo, Bossangoa.

PCI is implemented in CAR with activities to combat Covid-19 infection. Assessments were carried out asynchronously in different health facilities across the country and the results of these assessments were shared on the Kobo collect software. The score obtained from the last supervision of the month was 51. Which gave a national score of 54%.

The implementation of PCI activities required the training of actors at different levels of the health pyramid and also of actors from different “One health” sectors. All these IPC implementation activities were designed based on WHO or other country guidelines and standards. CAR has unique socio-economic, cultural and epidemiological contexts that require specific IPC approaches. National policies and standards must therefore be adapted to meet the specific needs and challenges encountered by the country. The country is therefore considering developing national strategic documents on IPC.

These terms of reference provide a clear framework for the recruitment for a period of 90 days of an International Technical Assistant and a National Technical Assistant to support the development of national strategic documents, a procedures manual and a training manual on Infection Prevention and Control in the Central African Republic. These documents will serve as a guiding framework for IPC policies, programs and interventions nationally. In order to further help health establishments implement the PCI strategy, this document will be popularized throughout the health pyramid.

2.1 Overview of the Global Fund HIV/TB/malaria program implemented by the French Red Cross Delegation in CAR

The French Red Cross is the principal recipient of the HIV, TB and malaria grant from the Global Fund in CAR for the period 2024-2026 and within this framework is responsible for the management and implementation of the activities planned with the support of the Ministry of Health and Population and partner Civil Society Organizations.

3. General and specific objectives of the consultancy mission

3.1 General objective of the consultancy mission

Develop national IPC strategic documents with the support of national and international technical assistance

3.2 Specific objectives of the consultancy mission

– Develop the national strategy for implementing a PCI Program
– Write the procedures manual for PCI in CAR
– Write the PCI training manual and validate it with stakeholders
– Propose the next steps for implementation/ extension of PCI in CAR

4. Methodology of the consultancy mission

Under the supervision of the Director of Healthcare Organization of the MSP and, in close collaboration with the manager of the Covid-19/RSS program at the French Red Cross, and the WHO PCI expert, the international consultant will propose a detailed timeline and methodology for the mission in accordance with the following tasks:
1. Conduct interviews with the various key stakeholders involved in IPC, in particular the WHO, the Coordination of the organization of care, those responsible for FOSA, etc.
2. Conduct an in-depth analysis of the current IPC situation in the Central African Republic, identifying gaps, challenges and opportunities.
3. Design a detailed work plan for the development of national strategic documents, taking into account national priorities, international best practices and consultations with stakeholders.
4. Develop a national IPC strategic framework, including a vision, mission, strategic objectives and key performance indicators.
5. Draft national policies and guidelines on IPC, incorporating WHO standards and adapting recommendations to local realities.
6. Develop an operational action plan for the implementation of the strategic framework, identifying the responsibilities of the different stakeholders and defining monitoring and evaluation mechanisms.
7. Organize validation workshops with the Ministry of Health and international partners.
8. Present to the technical committee the first drafts of the national strategy for implementing a PCI Program, a PCI procedures manual and a PCI training manual
9. Consolidate the final documents by taking take into account the contributions of participants

5. Expected results of the consultancy mission
– The overall report of the Assistance mission accompanied by the submission of the final documents are
available
– The national strategy document for the implementation of a PCI Program, The procedures manual for PCI, The PCI training manual validated by the steering committee are available

6. Expected deliverables

REMINDER: Remember to detail the expected deliverables as much as possible (number of pages, font, size, number of annexes, expectations for recommendations ranked by order of priority, summary in French and English, etc.)
– The strategy document national implementation of an PCI Program;
– The PCI procedures manual;
– The PCI training manual.
– The overall report of the Technical Assistance mission with the next steps

6. Organization of the consultancy and timeline
Phases of the consultancy
Phase 0. Framing of the mission, collection of information on the theme of PCI in the Central African Republic – 90 Days – based in Bangui – Dates 05/15 to 09/19/ 2024
Phase 1. The phase of defining themes and developing provisional thematic reports by the consultant and validated by the steering committee
Phase 2. The phase of developing and validating the strategic plan document
Phase 3. Submission of the document final
> Discussion times with the consultants will be planned between and during these different phases.
Chronogram
The consultancy will take place over a period of 90 days, i.e. from 05/15/2024 to 09/19/2024
Phase 0 : 05/15 to 05/31/2024
Phase 1: 06/03/ to 07/31/2024
Phase 2: 05/08 to 06/09/2024
Phase 3: 19/09/20224
> This timeline is a proposal which will be adapted by the consultants

7. Processing of offers
Profile of consultants
– Hold an advanced university degree (Master’s degree, or PhD) in a field related to medicine, or with a specialization in internal medicine/infectious diseases,
– Have experience proven in the design and drafting of national strategic documents in the field of health, preferably in Infection Prevention and Control.
– Have in-depth knowledge of infection prevention and control principles and practices, as well as international standards and guidelines.
– Have relevant experience in the field of IPC and a good understanding of public health issues in a resource-limited environment like the CAR.
– Have mastery of IT tools;
– Have perfect command of the French language, both written and spoken

– Have at least 5 years of field experience in the field of infectious disease control and specifically at least 3 years in the field of IPC.
– Having conducted similar consultancies in the past, including having led the development or review of documents in the field of the strategy for implementing an IPC program within the health pyramid or a supporting international organization to the Ministry of Health or regional organizations;
– Having worked at least once in the CAR or in a context with limited resources would be an asset

Administrative clauses
– The tenderer must provide proof at the time of submission of the regularity of his economic activity (tax documents, registration, registration as a self-employed worker – depending on the reference country where the tenderer is established).
– The bidder must be able to provide a medical certificate of professional fitness
– The service provider must alone provide the means necessary to carry out his service, whether material or human: plane tickets, computer, professional liability insurance, Visa.
– He can delegate part of the mission, within his teams, to the employee of his choice, but he remains the sole hierarchical and disciplinary authority concerning his employees. The service provider must ensure security, and as such insure the consultants sent on mission.