FHI 360 RFP for TBPS Project Patient pathway survey: Barriers and enablers of patient-centered TB services in Indonesia’s private sector

FHI 360 RFP Patient pathway survey: Barriers and enablers of patient-centered TB services in Indonesia’s private sector

USAID TB Private Sector is looking for a reputable Agency for providing Services on Patient Pathway Survey: Barriers and enables of patient-centered TB services in Indonesia’s private sector.

Background

The U.S. Agency for International Development’s (USAID) Tuberculosis Private Sector (TBPS) Activity supports the Government of Indonesia’s (GOI’s) goal of tuberculosis (TB) elimination by 2030. TBPS supports a vision for fully scalable, market-based and government-supported PPM programming that accelerates private-sector diagnosis, notification, and successful treatment to reduce TB incidence and mortality. To achieve this goal, TBPS will support Indonesia’s journey to self-reliance in achieving TB elimination targets by improving TB diagnosis, treatment, and case notification by private providers in six activity districts. One of the activities in this project aims at creating a patient pathway cascade that is representative of different genders, age groups, and other related factors that may affect patients’ barriers in obtaining treatment. This activity will be conducted in 5 activity districts to explore the current patient pathway condition in each activity districts and based on different demographic characteristics. This activity will look at patient behavior and the availability of TB health service to provide information on where TB patients experience delays during care seeking including treatment initiation, access inappropriate care, or are lost to follow-up during their journey toward cure in the private sector, with differences by gender, age group, and SES identified. In addition to that, this study will also provide recommendations for improving patient-centered TB care in the private sector that can be implemented by TBPS.

The role of the awarded agency will be to administer and manage the study, including performing data management and cleaning.

Scope of Work Administrative requirements The study activity will require activity permit to be issued to the awarded agency by the National Tuberculosis Program (NTP), Provincial Health Office (PHO) and District Health Office (DHO), to ensure that the data collection process runs smoothly. The activity permit by the NTP will be prepared by USAID TBPS PI, while the province and district level permits must be prepared by the awarded agency. The activity permit for each district must mention all the target health facilities and each health facility should get a copy of the permit prior to any activity at the health facility. The awarded agency has to select the point of contact for research coordinator in each study district to be responsible for regional and health facility level study permit. Sampling

USAID TBPS PI and the awarded agency will work together on selecting 35 out of approximately 91 private health facilities (i.e., hospitals and clinics). We will select the seven health facilities in each district using a simple random sampling method.

After selecting private health facilities together with USAID TBPS PI, research coordinators hired by the awarded agency must visit each facility to collect patients’ data as the sampling frame. The data will be collected from TB registry in health facilities’ TB clinics and also from the patients’ medical record. Since this is a very private data, this stage of data collection will be performed only by the research coordinators from the awarded agency and by support from DHO and the patients’ organization such as PETA and Aisyiyah, to ensure that the data collection process runs smoothly and privacy of respondents is well-kept. The inclusion criteria for patients in this stage include:

1. 18 years old

2. New drug sensitive TB case being treated in the selected private health facilities in the selected districts

3. Have been on treatment between 1 day to 168 days (6 months, @28 days). The next step is to interview the patients. By limiting the inclusion criteria to approximately 6 months, it is expected that the patient has undergone comprehensive TB care pathway and at the same time not too long ago to avoid recall bias

The exclusion criteria for this study are as follows:

1. Less than 18 years old

2. Presumptive TB patients who are not yet diagnosed with TB

3. MDR TB patients since their diagnostic method and treatment regimen are different from drug-sensitive TB patients. Thus, this group’s experience would not be comparable to drug-sensitive TB patients.

4. TB patients who have relapsed or have re-started treatment after failure/default

The sampling frame will be collecting information on initials, full address, and phone number from two sources:

1. Form TB-01 that can be found in TB clinic

2. Medical record of the TB patient

The sampling frame will be cross-checked with the health facilities, including to TB staff and/or medical record staff. Part of the cross checks include confirmation of initials, diagnosis, location of residence and contact number.

After the sample frame is collected, discussed, and agreed with USAID TBPS PI, the final respondent samples will be selected using a systematic random sampling approach conducted as the following:

1. Eligible study participants in each district and sex type will be sorted based on health facilities and address

2. Each respondent will be assigned a random number generated using excel =RAND() function

3. The random number will then be sorted from the smallest to largest

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January 2020

4. A constant number will be generated based on the total number of samples over the total cluster per district, namely n

5. Every nth respondent will be selected from the pool of sampling frame

The final sample list must try to contain a very minimum personal information, such as number, initials, and phone number to avoid personal identification. The procedure of sample list development will take at a maximum of two weeks to complete during which period the awarded agency and the research coordinators must communicate intensively with USAID TBPS PI.

Please submit the proposal before July 15, 2020 at 17.00 WIB (Indonesia time) to procurementindoTBPS@fhi360.org.