Call for Proposal RESEARCH EVALUATION ON CASE MANAGEMENT OF DR TB

Term of Reference

RESEARCH EVALUATION ON CASE MANAGEMENT OF DR TB

1.       Background

‘Aisyiyah (http://www.Aisyiyah.or.id/) is a Muslim women's organization founded in 1917 in Indonesia. ‘Aisyiyah is one of the largest non-profit religious women's organizations in Indonesia. This organization focuses on Islamic movement, da’wah, and tajdid in all areas of life including the field of health and education.

In New Implementing Period (2018-2020), ‘Aisyiyah has been chosen as Principal Recipient (PR) of Global Fund to carry out a “Community TB-HIV Care Program” to represent the Indonesian Civil Society. ‘Aisyiyah is responsible to coordinate community level activities of Sub-Recipients (SRs) as the representative of Civil Society Organizations (CSO’s) that currently covers 14 provinces and 130 districts/cities in Indonesia.

The aim of this NIP program is to reduce morbidity and mortality from TB and HIV in the 34 provinces in Indonesia. Another goal is to strengthen the health system and the community to be able to increase the achievement of TB control programs in Indonesia and to encourage successful treatment, especially patients suffering from TB MDR.

Indonesia is one of the countries with highest TB burden in the world. According to the Global TB Report (WHO, 2018), Indonesia’s TBC incidence in 2017 was 842,000 cases with estimated MDR/RRT TB around 12,000 cases. Taking into account the notification rate of 446,732 in 2017, only 53% of all cases have been found whereas the remaining 47% is either left unreached and untreated or has been found and treated but unnotified to the national program. Patients who have not been reached become a source of infection to people.

In Indonesia, one of the problems with poor outcomes of DR TB patient treatment is due to loss to follow up. According to one study in Surakarta, common causes of loss to follow up include the adverse effects of treatment, transportation cost, no escort, bored, and unable to work (Taufiqi, Harsini, and Aphridasari, 2016).[1]

In one of the recommendations from the WHO Report (2018) in addressing the problem of MDR TB were including the need for “much higher coverage of drug susceptibility testing among people diagnosed with TB, reducing under diagnosis of TB, models of care that make it easier to access and continue treatment, new diagnostics, and new medicines and treatment regimens with higher efficacy and better safety”.

Therefore, in line with the WHO recommendation and the common causes of loss to follow up, during the New Implementation Period (NIP), PR ‘Aisyiyah together with the Ministry of Health will utilize new approach in dealing with DR TB treatment. This is an effort to achieve the target of community assistance to DR TB patients from the beginning of being diagnosed to recovery and completion of the treatment period. Utilizing case management approach, at the District level (PMDT hospitals), there will be Case Managers who will manage and organize the roles of Patient Supporters, Peer Educators, and cadres to improve coverage of DR TB patient from the beginning to the end of the treatment period. Since this is a new approach, thus this evaluation research of the process and mechanisms of case management will be important to understand its effectiveness to improve better services for DR TB patient.

2.       Objectives

General Objectives:

The main objectives of this research evaluation on case management of DR TB are four-folds:

1)      To assess the implementation and management mechanisms of cases carried out by community at PMDT hospitals;

2)      To understand the roles and ways of working between case managers, peer educators, and patient supporters and with other stakeholders in hospitals and other health facilities;

3)      To understand the gaps in number laboratory confirmed DR TB patients and enrollment at the Districts levels (PMDT hospitals);

4)      To find out the problems with poor treatment outcomes at the District levels (PMDT hospitals).

Specific Objectives:

1)      To evaluate the role of community DR TB Team (Case Manager, Supporting Patients, peer educators and cadres) in case management processes.

2)      To understand the relationship between the DR TB Team, the community and relevant stakeholders (Provincial/ Districts/City Health Office, PMDT Hospital, PPM and Primary Health Center).

3)      To evaluate the flow of referrals to guide DR TB patients in the community.

4)      To evaluate the flow of recording, reporting and mentoring of DR TB patients by case managers, PS, PE, and cadres.

3.       Output

Outputs of this evaluation include:

1)      Research Evaluation Report in bilingual: Bahasa Indonesia and English.

2)      Documentation of the research evaluation raw data include transcripts and results from interviews, FGDs, and other document from the observations.

3)      Recommendations for program improvement.

4)      Final Report and materials for dissemination.

4.       Methodology

This research evaluation should incorporate mixed methods (qualitative and quantitative approach) for data collection and analysis, and include literature review on case management and DR TB, in-depth-interviews, surveys, focus group discussions, and field observation to understand DR TB treatment and issues.

5.       Scope of Work and Duration

Locations for this evaluation will be in 8 provinces and 10 cities/districts. The selection of locations will be based on certain criteria which to be discussed further with the TA.

This research will be done in 4 months (April - July 2019).

The consultants will be responsible for timely delivery of the outputs and deliverables and prompt reporting and presentation of raw data, draft and final report to PR TB ‘Aisyiyah (electronic and hard copy) in English and Bahasa Indonesia.

The consultants will work closely with and will send all deliverables to Research and Advocacy Coordinator of PR TB ‘Aisyiyah.

6.       Qualifications

1.       Eligible applicants are institution(s) or research organization(s) from university or civil society organization(s).

2.       Collaboration across disciplines and institutions/organizations are highly encouraged.

3.       Research Team/Personnel have experience in conducting similar research.

4.       Proven a good quality of research publications and disseminations.

5.       Capacity to use new technology and innovation.

7.       Submission Procedures

A.      The applicants should submit proposal with the following required documents:

1.              Expression of Interest.

2.              Organizational Profile.

3.              CV’s of Research Team/Personals.

4.              Sample of previous research report.

Expression of Interest for this Research includes following:

-          Technical Proposal consists of background, objectives, significant of study, methodology, conceptual frame work, proposed activities, implementation plan, and timeline. The consultants should also describe their experience in conducting similar research, and their experience in financial management.

-          Budget Proposal includes:

·         Research activities (75%)

·         Program management (incl. fees and administrative support) (not exceed 25%)

B.      Briefing session will be conducted at PR TB ‘Aisyiyah office, Jalan Tebet Timur Dalam Raya No 63, Tebet, Jakarta Selatan, on 20 March 2019, 13.30-15.30. This briefing session is not mandatory.

C.      Only shortlisted and qualified applicants will be contacted for presentation of research proposal.

D.      This research activity is expected to start in Mid April 2019.

Please send the Expression of Interest to: adminnip@pr-tb’Aisyiyah.or.id with subject line: “Expression of Interest - Research Evaluation _Case Management DR TB_name of applicant” by 1^st of April 2019..

The applicant can submit the proposal in English or Bahasa Indonesia.