To adapt of the Standardized package of supportive community-based services to improve TB outcomes and rationale for its costing in Ukraine

I. About TB Europe Coalition (TBEC)

Established in 2009, TBEC is a regional advocacy network of civil society organizations and individuals from across the World Health Organization (WHO) Europe region, comprising Western and Eastern Europe, Caucasus and Central Asia. The network aims to strengthen the role of civil society within the regional response to TB, and ensure political and financial commitments to end TB. Currently TBEC has more than 200 members from more than 30 countries in the region. In 2017, TBEC was registered as a legal entity in the Netherlands to step up its regional and national advocacy, capacity building and support to country-led TB advocacy initiatives. The TBEC Secretariat is located in Kyiv and responsible for the coordination, communication, administration, programmatic and policy management of the network.

TBEC’s primary role in the project is to support civil society organizations in their advocacy for people-centered TB care at the national and regional levels. In particular, TBEC develops regional policy and other relevant documents on the role of civil society in providing people-centered services for EECA countries and supports capacity development activities for civil society and community organizations.

II. Background information on the project:

Despite notable progress in the past decade, TB is still of public health concern in most of the countries within the WHO European Region. The Eastern European region has the highest rates of drug-resistant TB (DR-TB) in the world. According to WHO estimates, 17% of new TB cases and 53% of previously treated cases in the region had rifampicin-resistant TB (RR-TB) in 2017, compared to global figures of 3.5% and 18%, respectively. TB in Eastern Europe and Central Asia Project on Advancing People-Centered Quality TB Care – From the New Model of Care Towards Improving DR-TB Early Detection and Treatment Outcomes (TB-REP 2.0 Project), funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The project is implemented jointly by the partners: the Center for Health Policies and Studies (PAS Center) together with the World Health Organization Regional Office for Europe (WHO/Europe) and partners TB Europe Coalition (TBEC), TB People and Global TB Caucus (GTBC) and helps EECA countries cope with the high burden of TB and MDR-TB and bring TB treatment closer to patients. TB-REP 2.0 focuses on strengthening people-centered approaches to TB treatment through sustainable health systems transformation and meaningful community and civil society participation.

TB-REP 2.0 has been approved for a 3-year period, from 2019 to 2021. The project is covering eleven countries with high incidence of TB in EECA region, namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Turkmenistan, Ukraine, Uzbekistan.

III. Background information on the assignment:

One of key service delivery bottleneck in TB-REP countries is the insufficient engagement of civil society organizations and communities. Lack of extensive experience and good practices in the region on Civil Society Organizations (CSOs) contracting and evaluation of the results prevent governments from developing effective cooperation with civil society and communities. At the same time, there is a clear need for the patients that CSOs and communities become part of TB services provision, where possible, through building their capacities and designing regulatory frameworks for contracting.

In response to this challenge, the project supported the development of the Standardized Package of Community-Based Supportive Services to improve TB outcomes and its Costing Methodology (hereafter – the Standardized Package). Jointly developed by TBEC – PAS Center – WHO EURO, the Standardized Package is undergoing clearance by WHO EURO and will be published under WHO EURO umbrella.

In continuation to the blueprint[1] for the people centred model of TB care, this Standardized Package aims to further support countries in shifting towards outpatient, people-centered model of care by providing more holistic approach to the continuum of care, and hence, improving health outcomes and prevention of TB.

The Standardized Package defines the content and provides instructions for the provision of non-medical services to TB patients and groups of population that are at increased risk of TB. The document is intended to support countries in EECA region in the process of implementation of the people-centered model of care by providing recommendations and tools to engage community and civil society actors in the service delivery to better address the needs of patients and communities affected by TB, as well as to support healthcare providers. It provides national policy makers and community representatives with tools to set up supportive services for local communities and to cost those options for implementation purpose.

In the context of the above, TBEC is looking for a consultant to support Ukraine in adapting the Standardized Package to the needs of the country and calculating the cost of an appropriate set of supporting services.

IV. Goals and objectives:

The general objectives of this assignment are as follows:

• (i) adapt the Standardized Package of Community-Based Supportive Services and its Costing Methodology, in the form of a regulatory document, in accordance with the needs and procedures of the country, including the financial and economic rationale of the regulatory document, which will approve a standardized package of tailored supportive TB services.
• (ii) support of the approval process of this regulatory document, including holding public discussions and all necessary approvals;
• (iii) adapt an electronic supportive tool for calculating the cost of a tailored services package for Ukraine.

The adaptation of the supportive services package and its Costing Methodology will be carried out under the guidance of the state institution, the Public Health Center of the Ministry of Health of Ukraine, which performs the functions of coordinating the National TB Program (NTP), is the main recipient of the GF project, implements the Transition Plan, and after consultations with other TB stakeholders, including CSOs and representatives of TB-affected communities

V. Scope of work:**

The scope of this work is to provide technical assistance to the Public Health Center of the Ministry of Health of Ukraine in the adaptation of the Standardized Package of Community-Based Supportive Services in accordance with the needs of the country, as well as adaptation of an electronic supportive tool for calculating the cost of a tailored services package for Ukraine .

The costing methodology for supportive services is an integral part of the Standardized Package and provides a practical costing tool for predicting the cost of supportive TB services at the community level and thus supports the implementation of the package.

The consultant is expected to:

1. Develop a Roadmap for the implementation of the Standardized Package in Ukraine, which will contain:

• Justification and selection of the optimal status of the regulatory document for the approval of the Standardized package in Ukraine;

• Review of existing developments of stakeholders in Ukraine for their compliance with the values, principles and logic of the Standardized package and the possibility of their further use in the process of adapting the Standardized package;

• Proposals of further organizational steps to develop and support the approval of a regulatory document regulating a package of supportive TB services adapted to the needs of the country and its costing methodology.

This “Roadmap”, in agreement with the Public Health Center, should be drawn up in the form of a draft Analytical note and coordinate the actions of all national stakeholders, including initiative group for adaptation and implementation of the Standardized package.

1. Develop a detailed structure of the draft regulatory document (which will approve the tailored supportive services package and its costing methodology), as well as propose content for each section (to be finalized by a national consultant), that will include:

• Sections of the regulatory document, including Annexes to it;

• Synopsis of the content of these sections;

• Model description of one service in Ukrainian language.

1. Prepare a detailed draft terms of reference for the national consultant and coordinate the further organization of work on the design and filling of the content of the regulatory document in accordance with the agreed structure by the national consultant, including the adaptation of the electronic supportive tool for calculating the cost of a tailored services package for Ukraine.
2. In coordination with the Public Health Center:

• Will take part in working and initiative groups and present the developed Roadmap and the draft regulatory document, as well as the Standardized package to a wide range of stakeholders at relevant meetings and presentations, including the working group on the development of a new version of the Law of Ukraine ” On Fight against Tuberculosis” with proposals to introduce provisions on the supportive TB services, as well as a proposal for the structure of the draft law;

• Advise the Public Health Center and the national consultant in the process of agreeing and adoption of the regulatory document, which will approve a standardized package of supportive TB services adapted to the needs of the country, as well as its costing methodology.

VI. Deliverables**:**

Activities

Deliverables

Deadline

Number of days (maximum)

Develop a Roadmap for the implementation of the Standardized Package in Ukraine

Draft Analytical note (in coordination with the Public Health Center) containing the Roadmap for the implementation of the Standardized Package in Ukraine

20.08.2021

4 days

To develop the detailed structure of a draft regulatory document, which will approve a Standardized Package and its Costing Methodology adapted to the country needs, in Ukrainian, including its financial and economic rationale, with the proposed content for each section (the content will subsequently be finalized by the national consultant)

The structure of the regulatory document, which will include:

• Sections of the regulatory document, including Annexes to it;

• Synopsis of the content of these sections;

• Model description of one service in Ukrainian language.

30.08.2021

6 day

To develop Terms of reference for the national consultant

Draft detailed Terms of reference for the national consultant

25.08.2021

0,5 days

To develop the proposals on amending the new version of the Law of Ukraine “On Fight against Tuberculosis” regarding provisions on the supportive TB services, as well as proposals for the relevant structure of the draft law.

Proposals to amend the new version of the Law of Ukraine “On Fight against Tuberculosis”:

• provisions on the supportive TB services

• the structure of the draft law

30.08.2021

1 days

Preparation of an interim progress report

An interim progress report (no more than 3 pages in Russian or English), reflecting all the actions taken to fulfill this Terms of Reference, the difficulties encountered and the proposed / taken ways to solve them, the results achieved, as well as adjustment of the timing / activities of the Road map in line with the progress made.

15.09.2021

–

In coordination with the Public Health Center and the TBEC: coordination of the further work of the national consultant on the design and filling of the content of the regulatory document in accordance with the agreed structure, including the adaptation of the electronic supportive tool for calculating the cost of a tailored services package for Ukraine

Communication with the national consultant, comments and feedback (at the request of the Public Health Center and the national consultant)

15.11.2021

3

At the request of the Public Health Center and TBEC: provision of technical and advisory support (including revision / introduction of necessary changes to the Roadmap, draft regulatory document, advising to the Public Health Center and the national consultant in the process of agreeing (in ministries and public discussion) and adoption of the regulatory document, which will approve a standardized package of supportive TB services adapted to the needs of the country, as well as its costing methodology, preparation of responses in the process of agreeing a regulatory document; participation in working and initiative groups: presentation of the developed Roadmap and draft regulatory document, as well as the Standardized package to a wide range of stakeholders at relevant meetings and presentations, including the working group on the development of a new version of the Law of Ukraine “On Fight against Tuberculosis ”

Communication with the national consultant, comments and feedback (at the request of the Public Health Center and the national consultant)

Presentations and speeches at stakeholder meetings:

• meetings of the initiative group (Public Health Center and key partners);
• wider meetings of national partners;
• a working group on the development of a new version of the Law of Ukraine “On Fight against Tuberculosis “

15.11.2021

2

Final Report Preparation

The final report (no more than 3 pages in Russian or English), reflecting all the actions taken to fulfill this Terms of Reference, the difficulties encountered and the proposed / taken ways to solve them, the results achieved, as well as a detailed description of how the main provisions of the Standardized package have been adapted into a national package, and if necessary, the timing / activities of the Roadmap adjusted in accordance with the progress made.

15.11.2021

–

VII. Reporting requirements

The consultant will work under the guidance and control of the Public Health Center and the TBEC secretariat and deliver the results within the contractual deadlines. All documents referred to in section VI. Deliverables (exception progress reports) should be submitted in the Ukrainian language, progress reports (intermediate and final) – in Russian or English in the format of Microsoft Office documents, in electronic copies for the TBEC Secretariat, in particular, to the TBEC program manager, Kira Grozava grozava@tbcoalition.eu

The Consultant is obliged to inform the TBEC Secretariat in a timely manner about all circumstances / reasons for possible delays / changes in the schedule for achieving results.

If necessary, the Consultant refines the prepared deliverables (Roadmap, Regulatory document, Progress reports) and other documents referred to in section VI. Deliverables before final approval by TBEC.

VIII. Duration of the assignment and terms of payment:

• The provision of consulting services will begin immediately after the signing of the relevant agreement.

• Consulting services must be provided between August 12 and November 15, 2021.

Payment for the services of the Consultant will be made on the following conditions:

• The fees will be paid in US dollars, therefore the consultant must have a bank account in US dollars.

• The consultant will be responsible for paying taxes in accordance with the laws of his / her country of residence.

• Remuneration will be paid to the consultant in 2 parts after the submission and acceptance of the results in accordance with clauses VI. “Deliverables” and VII. “Reporting requirements”.

IX. Qualification requirements

The qualification requirements for the selection of a consultant are:

General qualifications:

· University degree in public health, healthcare management or similar fields

· At least 5 years of professional experience in the area of public health and health policy

Adequacy for the assignment:

• A minimum of 5 years of progressive experience in TB programs management, including health systems strengthening for comprehensive TB care
• Work experience in / with central executive authorities, including providing technical and managerial support for the process of preparation and adoption of regulatory documents in the field of combating TB
• Proven understanding of people-centered TB care approaches as well as understanding of TB service delivery system in Ukraine
• Knowledge of administrative systems, procedures and processes of legislative-making and health care systems in Ukraine
• Good knowledge of health budgeting processes in Ukraine
• Experience in defining, costing and integrating community-based services into the health system will be considered an asset
• Previous experience working with the Public Health Center, the TB Europe Coalition, ministries, international organizations and / or national agencies implementing externally funded programs and projects is an asset.

Language and other qualifications:

· Proficiency in Ukrainian and Russian or English (spoken and written)

· Advanced computer skills

· Excellent communication and analytical skills

· Ability to work independently or in team, respond to feedback in a timely and professional manner, and meet deadlines

[1] https://www.euro.who.int/en/health-topics/Health-systems/health-systems-response-to-tuberculosis/publications/a-people-centred-model-of-tb-care-2017