Terms of Reference to engage a consultant physician/firm to provide emergency home based clinical care services for COVID-19 affected staff & families

1. Background

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that was first recognized in Wuhan, Hubei province, China, in December 2019. The COVID-19 pandemic has unprecedented effect on the health and socio-economic status of the world population. As of July 4^th, 2021, more than 186,053 cases and 3690deaths are registered in Kenya. Over the last one year, the government of Kenya has taken several measures such as travel and gathering restrictions, use of Personal protective Equipment (PPE) and introduction of the COVID-19 vaccines for vulnerable population.

Recently the number of cases and admission to the intensive care units (ICU) in Kenya have increased dramatically. Designated COVID-19 treatment centers are currently reporting shortage of supplies such as oxygen and ventilators to save the lives of severe COVID-19. With cases with new variants increasing the number of severe cases are more likely to increase beyond the capacity of the health system in the coming months.

Nutrition International (NI) has taken bold steps to ensure its staff safety and security in the last one year. Work from home (WFH) has been implemented globally over the last one year. NI also approved COVID-19 emergency funding to avail basic preventive measures such as PPE for its staff. Furthermore, NI has a plan to implement home-based care approach to ensure the safety and wellbeing of its staff in case of hospitals being overcrowded and overwhelm the health system.

2. Rationale of recruiting a consultant physician/firm

The increasing number of severe cases of COVID-19 in Kenya could be beyond the capacity of COVID-19 treatment centers in Kenya. On the other hand, shortage of life saving medications and equipment will be a serious challenge for the country to save the lives of with severe cases of COVID-19. In line with its principle of investing on its staff, NI will provide support for staff affected by COVID-19, including assist in home-based care in case of health service failure through hiring a medical practitioner/firm to provide emergency home based care clinical and counselling services to affected NI staff and their immediate family members. and prepositioning oxygen concentrator and other commodities, as necessary. The purposes of recruiting consultant physician/firm include:

Ø To offer a comprehensive home-care package consisting of quality clinical services (including doctor home visits, teleconsultation, home care nursing, laboratory services, delivery of prescription drugs at home, nutritional consultation, physiotherapy services, fumigation & clinical waste management at home) to NI employees with severe form of COVID-19 disease in the absence of functional health system.

3. Specific duties and responsibilities of the consultant physician/firm

Table1: Checklist for the consultant’s scope of Work

Objective

Activities **

Provide lifesaving clinical services for employees with severe form of COVID-19.

· Conduct home visits by doctors followed by teleconsultation for medical history, examinations and laboratory tests and develop a management plan

· Provide lifesaving medications such as IV fluids, antibiotics, antipyretics and corticosteroids. The consultant physician is responsible to procure and avail the lifesaving medications.

· Administer oxygen to severe cases at home as per the national guideline. Oxygen concentrator will be provided by NI.

Provide counseling and psychosocial services for the patient and families

• Provide physiotherapy, home-based care and nutrition counseling to the patient and their families remotely and physically as needed.

• Provide fumigation and safe medical waste management at home to prevent transmission of Covid 19 or other infections among family members

4. Key Deliverables and timeline

S. No

Deliverables

Timeframe

1. Monthly update report including treatment outcomes of patients to the country direct

Report on each case managed within 3 days of providing care.

1. Simplified home-based care protocol including use of oxygen concentrator

August 2021

5. Qualifications of the consultant

The consultant physician should have an MD degree and specialty in internal medicine or infectious diseases from known Kenyan Universities. He should be certified clinician and have at least 5 years of service in Kenya.

6. Reporting and working hours

The consultant physician shall report to the CD weekly. He shall work on call basis as needed based on the availability of patients.

7. Duration of consultancy service and contract Period

The consultant will be engaged on need basis.

8. Selection/Remuneration

The consultant physician or firm will be recruited based on competition. The consultant shall submit a technical proposal (based on the above objectives and scope of work) and financial proposal (based on cost of consultation /patient and cost of medicines and supplies for COVID-19 treatment) to NI by July 30,2021.