1. Assessment of the Impact of COVID-19 on Immunization delivery System
World Health Organization(WHO)
CONSULTANCY ANNOUNCEMENT
WHO Rwanda in Collaboration with Rwanda Biomedical Center (RBC) is inviting suitable qualified consultancy firm to apply for the following consultancy:
Title: Assessment of the impact of COVID-19 on immunization delivery system
Date issue: 25/05/2021
Deadline: 07/06/2021
1. Background
The COVID-19 pandemic has drawn worldwide attention and a global response. All the countries and areas have initiated measures to contain, mitigate transmission and reduce the impact of the outbreak on health-care systems, including shifting health-care resources to the COVID-19 response. Implementing prevention measures such as physical distancing at all levels of society, travel restrictions and closures of international borders, and community quarantines at subnational or national levels resulted in the slow of COVID-19 spread in many countries. However, the COVID-19 disease and its prevention measures have impacted negatively the socio-economic development and health services delivery system.
The immunization is a core health service that could be affected by measures put in place to control the pandemic. The COVID-19 is putting pressure on global manufacturer production capacities, supply availability and logistics, with the risk to affect the continuation of immunization services in countries. Instituting of lockdowns, travel and mass gathering restrictions to contain the spread of the virus have also impacted the logistic, the demand for immunization and vaccination service delivery by limiting the visits of the community to the health facilities for seeking health services including immunization and causing the suspension of immunization outreach services. This may result in the low uptake of the vaccination leading to the decline of immunization coverage.
The risk of disruption to routine immunization activities due to both COVID-19 related burden on the health system and decreased demand for vaccination because of social distancing requirements or community reluctance is also high. Disruption of immunization services, even for brief periods, would result in increased numbers of susceptible individuals and raise the likelihood of outbreak-prone vaccine preventable diseases (VPDs) such as measles.
2. Justification
In Rwanda, the first case of COVID-19 was confirmed on 14 March 2020. As of 28 April 2021, 24,888 people were affected, and 332 people died of the disease. Immediately after the confirmation of the first case, lockdowns, travel restrictions measures and closure of the schools were established to control the spread of the outbreak in the country. These measures may have affected vaccination services in one way or another. Supply chain and immunization services delivery may have been affected by the interruption/ slowing of international movements and trade; lockdowns and travel restriction. Compared to 2019, the average of coverage for DPT3 decreased by 9.9% in 2020, while the Measle rubella coverage reduced by 3.8%. About 44,797 children missed their DPT and Polio3 vaccines and 44,086 were not vaccinated against Measles and Rubella. In view of these challenges, the Ministry of Health expressed the need of assessing the impact of COVID-19 on immunization delivery system. This assessing is critical for a deep analysis of factors that may have contributed to the low immunization coverage. It will also help to document best practices, challenges and mitigation measures that can be implemented in the future to achieve and maintain high performant immunization system. The WHO will provide necessary support for the design, implementation of the assessment, as well as dissemination of the findings.
3. Objectives
The main objective of this consultancy is to design and implement the assessment, to identify COVID-19 related factors that may have affected the immunization service delivery during the pandemic as well documenting best practices and innovations to overcome the challenging situations. All the key components of immunization system will be assessed
Specific objectives:
- Evaluate program operations, financing and human resources management during COVID-19 pandemic at national and subnational level
- Review the vaccine and ancillary supply management system and logistic and identify their level of adaptation to respond to vaccines demand during COVID-19
- Identify internal and external barriers to immunization service delivery, VPDs and AEFIs surveillance at all level of the immunization and VPDs surveillance system during COVID-19 outbreak
- Appraise the immunization data management system and utilization for monitoring the progress of coverage
- Examine the communication strategies and flow, and identify any changes caused by COVID-19 which may have affected the demand generation for vaccination
- Document best practices and innovations that were implemented to overcome challenges caused by COVID-19 pandemic
4. Work assignment
The consultant or firm will be requested to conduct the following activities:
- Design the protocol for the assessment and assessment questionnaire
- Submit the assessment protocol for ethic approval
- Conduct a deep desk review to evaluate immunization program operations, monitoring and evaluation at all level of the immunization system during COVID-19 pandemic
- Organize and facilitate the orientation workshop for data collection and supervision
- Organize and supervise the field activities for data collection
- Perform data entry, cleaning and analysis and draft the preliminary assessment findings
- Organize and facilitate meeting to present the preliminary findings
- Elaborate assessment report and facilitate the dissemination workshop
5. Deliverables
Submission of inception report which include the situation analysis, methodology for the implementation and timelines for the completion of the assessment
- Finalizing the assessment design, data collection tools, and organizing the orientation workshop
- Preliminary report drafted and findings review meeting organized
- Final report submitted
6. Scope of work
The work will be performed in collaboration with the Maternal Child and Community Health (MCCH)/Vaccine Program Unit and the Public Health Surveillance Emergency Preparedness and Response (PHS&EPR) division within the Rwanda Biomedical Centre (RBC). RBC will provide necessary support to the consultant firm such as facilitating communication with relevant stakeholders for a smooth implementation of the activities.
7. Qualification
The consultancy firm should:
- be registered in RDB. This registration is proven by the provision of a certificate from RGB.
- have public health experts with extensive working experience in public health research including design and implementation of nationwide surveys
- prove capacity to carry out the scope of work with a professional team able to undertake the research activities evidenced by detailed CVs of key staff
- have good understanding of the Rwanda health and immunization system
- have capacity to elaborate and present documents in English
8. Proposal documents and submission
The consultancy firm will submit proposal which comprises the technical and financial details. The technical proposal should be a narrative which includes the proposed approach, methodology and timeframe for each deliverable. Staffing structure, including staff CVs with completion certificates of research activities undertaken in the past, details of days per team member articulated against a workplan of activities should be also included. The financial proposal includes activities and budget details.
Interested firms shall submit their proposals with their full address to afwcorw@who.int
9. Selection and contract signing
After analysis of proposals and interviews, WHO Rwanda will notify the winner in writing and call for discussion followed by contract signing if fully agree. The work is expected to start immediately after contract signing.
WHO Rwanda reserves the right to cancel any or all the proposal without assigning any reason thereof.
Done at Kigali, 19th May 2021
Dr Kasonde MWINGA
WHO Representative/Rwanda
Attachment: CONSULTANCY ANNOUNCEMENT IMMUNIZATION ASSESSMENT
2. National Consultancy firm to support integration of immunization e-Tracker and Civil Registration and Vital Statistics (CRVS) systems, organize training of end users and update legacy data in the immunization e-Tracker system
CONSULTANCY ANNOUNCEMENT
WHO Rwanda in Collaboration with Rwanda Biomedical Center (RBC) is inviting suitable qualified consultancy firm to apply for the following consultancy:
Title: National consultancy firm to support integration of immunization e-Tracker and Civil Registration and Vital Statistics (CRVS) systems, organize training of end users and update legacy data in the immunization e-Tracker system
Date issue: 25/05/2021
Deadline: 07/06/2021
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1. Background
The immunization data plays an important role in monitoring the progress and performance by providing evidence for the success or failure of immunization program and supporting planning for improvement and sustainability of the gains. Poor quality immunization data threatens to compromise investments, impairs monitoring of global, regional and national initiatives, and can increase the risk of vaccine preventable diseases (VPD) outbreaks by failing to identify areas or populations with low vaccination coverage.
In the context of improving the quality of immunization data the Ministry of Health has embarked on the use of digital technologies to increase the generation of real time data that can support timely decision for immunization service delivery. The immunization e-registry (e-tracker) was therefore developed into DHIS-2 and deployed in all health centers delivering vaccination services.
The repurposing of immunization key staff to support the response to COVID-19 pandemic affected all the components of immunization program including data management and e-tracker. The EPI supervisors, data managers and vaccinators were overstretched by supporting COVID-19 response activities such as COVID-19 active surveillance, contact tracing, infection prevention and control (IPC), home based care and data management. This created additional work which led to the reduction of time allocated to immunization data entry in the e-tracker system resulting in the accumulation of missing data in the immunization data management system.
2. Justification
The upcoming planning for the next five years of immunization includes the development of comprehensive Multiyear plan (c-MYP 2022-2026) and the measles elimination strategic plan for the next five years. All these plans will need to have quality data to appraise the current situation of the vaccination, support to define strategic interventions and targets for the next five years; and facilitate monitoring the progress against the achievement of global, regional and national immunization targets. In addition, the integration of Civil Registration and Vital Statistics (CRVS) system with the immunization e-Tracker will facilitate the generation a unique identifier (ID) and quick access to sociodemographic data for the parents and child, hence shortening the time required for registering and updating the vaccination status for the child.
Given that all these developments were necessary to improve the quality of immunization data for well informed decisions, the Ministry of Health indicated the need of integrating the CRVS with e-Tracker system, building capacity of end user for efficient operationalization of the system and updating legacy data so that accumulated missing data can be entered into the system and used as required.
3. Objectives
The main objective of the consultancy is to support the MOH to integrate the immunization e-Tracker system with the CRVS system and update immunization data into the e-Tracker system Specifically, the consultancy firm will:
- Integrate the immunization e-tracker and CRVS systems
- Build capacity for the end user of the e-Tracker system for efficient use of the system
- Update immunization legacy data in the e-Tracker system from January 2020 to June 2021
4. Work assignment
The consultancy firm will be requested to conduct the following activities:
- Develop features for the integration and interoperability of e-tracker and CRVS systems
- Conduct testing of the functionality of features at the immunization service delivery points
- Update the immunization e-Tracker user guide to integrate the elements of CRVS
- Organize and facilitate refresher training for the end user of the system
- Support health centers to enter immunization legacy data from January 2020 to June 2021in the e-Tracker system
5. Deliverables
- Integration of e-tracker with CRVS completed, tested and e-tracker user guide updated and disseminated to the end users
- Training completed and all the end user trained on the system utilization
- Immunization data updated for all the health centers
6. Scope of work
The work will be performed in collaboration with the Maternal Child and Community Health (MCCH)/Vaccine Program Unit within the Rwanda Biomedical Center and Health Information Management System (HIMS) within the Ministry of Health. The RBC/ vaccine program unit will provide necessary support to the consultancy firm such as facilitating communication with relevant stakeholders for a smooth implementation of the activities.
7. Qualification
The consultancy firm will work in close collaboration with technical staff from the RBC/EPI for the implementation of the activities. Firms applying for this work must meet the following qualifications:
- Being registered in Rwanda Development Board (RDB). This registration is proven by the provision of a certificate
- Proven extensive working experience on DHIS-2 software features development and integration
- Being knowledgeable of the features and functionality of CRVS system
- Have good knowledge of the health information system and data flow in Rwanda
- Having worked on DHIS-2 immunization e-Tracker in the past would be an asset
8. Proposal documents and submission
The consultancy firm will submit proposal which comprises the technical and financial details. The technical proposal should be a narrative which includes the following:
- Firm expertise and experience;
- Proposed approach, methodology and timeframe for each deliverable;
- Details of days per team member articulated against a workplan of activities
- Staffing structure, including staff Curriculum Vitaes (CVs);
- Work completion certificates;
The financial proposal includes activities and budget details.
Interested firms shall submit their offers with their full address to afwcorw@who.int
10. Selection and contract signing
After analysis of proposals and interviews, WHO Rwanda will notify the winner in writing and call for discussion followed by contract signing if fully agree. The work is expected to start immediately after contract signing.
WHO Rwanda reserves the right to cancel any or all the proposal without assigning any reason thereof.
Done at Kigali, 19 May 2021
Dr Kasonde MWINGA
WHO Representative/Rwanda
