SHORT TERM CONSULTANCY FOR ASSESSMENT AND DEVELOP THE ROADMAP FOR CAMBODIAN HIV STRATEGIC INFORMATION SYSTEM
Purpose of the Consultancy
The World Health Organization (WHO) would like to recruit an experienced consultant to work with the National Center for HIV/AIDS, Dermatology and STD (NCHADS) to lead a review of the Cambodian HIV Strategic Information (SI) system and provide recommendations on how to strengthen and scale up the national SI system to support attainment of Cambodia’s national goal of virtual elimination of new HIV infections by 2025.
Background
Cambodia has set goals in their national HIV Strategic Plan to reach the 90-90-90 targets by 2020, reduce HIV mortality, and eliminate new HIV infections by 2025. Development and scale-up of a robust strategic information system is one of 8 cross-cutting key strategic components in this strategy. A national strategy for monitoring and evaluation of the health sector HIV strategy has been developed, which states that the objective of the HIV strategic Information system is:
1. To provide the evidence basis for tracking progress and guiding implementation of the Strategic Plan through routine monitoring, operational research, surveillance, and evaluation.
2. To strengthen Boosted Integrated Case Management to improve HIV cascade outcomes towards the 90/90/90 targets.
One of the five requirements for B-IACM is the development of a linked database across the whole cascade. The SOP for B-IACM-PNTT (partner notification tracing and testing) states “This strategy should be divided into 2 phases: medium term and long term. Medium term: linking databases across the entire cascade and TB-HIV and PMTCT cascades; long term: integration into the PMRS system…..Critical for such linkages is a unique identification system.” In addition, NCHADS has outlined plans for Integrated Case Surveillance of HIV and STI (ICSHS). The goal of ICSHS is to identify and record all cases of HIV infection, both new and old. Strengthening of strategic information systems is necessary for robust ICSHS.
Several SI databases currently exist under NCHADS/ MOH to monitor key programmatic outputs and outcomes including the VCCT database, B-IACM database, pre-ART/ ART database, STI database, HEI (HIV Exposed Infant) database, pediatric database, viral Load, and an Exposed Infant Diagnoses (EID) lab database. Under the MCHC/ DPHI HMIS system, there is also a web-based application used for reporting aggregate data on HIV testing from health centers (including antenatal care) and outreach testing. NCHADS is also developing a database for key population prevention services that contains essential data from non-governmental organizations regarding their work with key populations (KP) that includes introduction and use of a unique identifier code (U-UIC) to allow tracking individuals through the cascade.
NCHADS has developed a vision for the HIV SI system which would facilitate tracking patients through the cascade through a patient lookup system. This system would serve as a master repository for all patient identifiers assigned to the patient, including identifiers used by HIV services, laboratory services, TB program, MCH program, or administrative systems such as Health Equity Fund (HEF), for example. This planned NCHADS HIV SI system would be based on electronic databases and internet connectivity to all 69 VCCT and OA/ART sites.
In 2017 NCHADS made great strides to link the existing NCHADS databases by developing and Electronic Master Patient Index System (EMPI) that could allow linkage of HIV patients not only between NCHADS clinical and laboratory databases, but also with databases used by other programs such as TB, inpatient care, clinical laboratories, and/or administrative systems such as HEF. In addition, they have worked with the Cambodian Communicable Disease Center to adapt a national 115 mobile phone disease reporting system to also facilitate identification of newly identified HIV infections for rapid mobilization of the B-IACM system (already deployed in Siem Reap and Battambang provinces). Additionally, NCHADS is exploring use of fingerprint technology to improve deduplication of ART clients, barcodes to streamline processing of viral load laboratory specimens, and line-listed VCCT and STI databases. NCHADS is also in the process of installing a system for remote cloud-based printing of viral load test results in order to decrease viral load result turnaround time.
In terms of data use, NCHADS has established an SOP for Continuous Quality Improvement (CQI) in which ART clinic staff meet quarterly to review measures of HIV clinical care. Quarterly review of data is an essential foundation for these meetings. In addition, NCHADS is strengthening use of data at the provincial and district level for B-IACM through routine Group of Champions meetings. Although some HIV staff members have been trained to do routine analyses for CQI and B-IACM meetings, use of dashboards is a way of facilitating analysis and increasing use of data by a much greater number of HIV program staff to ensure that decisions are evidence-based. Through a collaborative process with national stakeholders, NCHADS has designed dashboards for B-IACM and will also use a similar process to design CQI dashboards. However, these dashboards have not yet been fully programmed.
Furthermore, much of the care provided to patients throughout the cascade is still not tracked in line-listed electronic databases. Currently only approximately 54 of 69 ART facilities use electronic ART databases. Furthermore, although they are line-listed, these databases are not yet linked via internet to the central database. VCCT clinics do not have electronic, line-listed data, except for a handful participating in a pilot project in Battambang and Banteay Meanchey which uses a finger-print identification system. In addition, all referral hospitals now assign a unique health identification (UHID) number (the PMRS number, Patient Medical Registration System) to either all patients seen for general hospital services, or just those patients eligible for HEF patient benefits and provider compensation. But, there is not yet a routine process for ensuring all HIV patients have been assigned PMRS numbers, or that HIV service delivery for HEF patients is reimbursed.
Therefore, an independent assessment of the progress Cambodia has made in strengthening their HIV SI system is needed before full-scale up of the system is undertaken, to ensure the system is optimally fit for purpose, sustainable, and able to produce high quality, actionable data. Ideally this assessment would be led by an independent consultant who would be responsible for generating a full assessment report, with findings coming from not only the consultant, but also a team of international and national experts in key areas such as surveillance and health systems informatics. Such an assessment is essential for ensuring a clear roadmap for HIV SI system strengthening as Cambodia prepares for EMTCT of HIV and syphilis, as well as elimination of HIV by 2025.
Planned timelines (subject to confirmation)
Start date: 1 May 2018
End date: 30 June 2018
- A total of 35 working days (14 working days in country plus 21 working days working remotely )
Work to be performed
Description of activities to be carried out:
The STC will lead a team of international and national experts in the assessment of the national HIV information system.
This will entail:
- Finalizing a methodology for the assessment
- Coordinating and conducting the assessment jointly with an assessment team that involves NCHADS, WHO, UNAIDS, PEPFAR, and other key stakeholders
- Producing a roadmap summarizing key recommendations for strengthening and scale-up of HIV information systems for 2018 through 2025.
Method(s) to carry out the activity
Output/s
- Output 1: Finalized methodology and timeline for HIV SI system assessment based on existing WHO and UNAIDS guidance
Deliverable 1.1: Work independently to develop methodology for the assessment which is to identify next steps and key recommendations for strengthening and scale-up of HIV information systems in Cambodia that will serve as a road map for 2018-2025.
The key assessment questions will include:
- What is currently planned and funded in terms of HIV SI system development in Cambodia?
- What additional system enhancements would be needed for a system that is fit for purpose, sustainable, and able to produce high quality, actionable data to support EMTCT of HIV and syphilis and elimination of HIV?
- What is needed to improve interoperability with other health information systems in Cambodia?
- How could data analysis and use be improved?
- What are the workforce capacities needs to be able to implement the roadmap?
- Deliverable 1.2: work with NCHADS to coordinate the meeting of Strategic Information Technical Working Group to discuss and comment on the assessment concept note, methodology, and have it finalized.
- Output 2: Report summarizing findings, and recommendations for the roadmap to strengthen and scale-up of HIV information systems to NCHADS and key partners over the short (2018), medium (2019-2020) and long term (2021-2025)
- Deliverable 2.1: Take lead to coordinate and conduct the assessment jointly with an assessment team that involves NCHADS, WHO, UNAIDS, PEPFAR, and other key stakeholders
- Deliverable 2.1: Draft report on the road map developed from assessment recommended for short, medium and long term for strengthening and scale up HIV information systems, and present it in the Strategic Information Technical Working Group for discussion, comments and finalizing
Technical Supervision
The selected Consultant will work on the supervision of:
Responsible Officer: Dr Deng Serongkea, National Professional Officer for HIV, KHM/HIS
Email: dengs@who.int
Manager: Dr Laurent Ferradini, HIV/Hepatitis/STI Team Leader
Email: ferradinil@who.int
Specific requirements
- Qualifications required:
- Master’s degree in health science or public health or related field
- Experience /technical skills and knowledge required: - At least 5-years of experience working with HIV information systems in developing countries
- Language requirements: - Fluent written/spoken English
Interested should submit the following documents to wpkhmprocurement@who.int by 20 April 2018. Please use Tender Notice No. 70097 as subject to all submissions.
- Expression of Interest
- WHO personal history form or CV
- Proposed consultancy rate
Please note that the application may be closed before the indicated closing date if a sufficient number of applications are received. Only the successful candidates will be contacted
Competencies
- Ability to work in a team
- Ability to work under pressure
- Produce and deliver quality results
Place of assignment
- Location: Phnom Penh, Cambodia
- National Center for HIV/AIDS, Dermatology and STD (NCHADS)
- #245H, Street 6A, Highway 6, Phum Kean Khlang, Sangkat Prekleap Russey Keo, Phnom Penh
Medical clearance
The selected Consultant will be expected to provide a medical certificate of fitness for work
Travel
The STC is expected to travel one time each in Battambang (estimated 3 nights) and Siem Reap (estimated 3 nights) province to assess the current status of HIV Strategic Information System at Sub national level. Date is to be determined
All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance.
Visas requirements: it is the consultant’s responsibility to fulfil visa requirements and ask for visa support letter(s) if needed.