Request for Proposals (RFP) Kisumu County Community Health Program Mixed Methods Evaluation at Living Goods

In Kenya, we partner and support national and county governments to drive improved health outcomes nationally, and to embrace and own the main elements of the DESC approach, in which community health workers (CHWs) are Digitally enabled, Equipped, Supervised, and Compensated (DESC).

LG aims to drive greater impact by supporting the Kenyan government to sustainably operationalize and finance its own community health systems at scale. To do this, we are partnering with County Governments and other partner organizations to co-design and operationalize DESC more broadly and align with governments goals.

Kisumu County recently signed a memorandum of understanding with Living Goods. In this agreement, LG will provide technical assistance to Kisumu County based on over 10 years of experience in supporting community health programs in Uganda and Kenya. By leveraging the DESC community health program, households will have increased access to timely and quality maternal, newborn, and child healthcare services which will consequently improve maternal, newborn and child health outcomes.

In its partnership with Kisumu County, Living Goods will provide digital tools and capacity building on DESC Implementation and performance management. Kisumu County will provide access to essential medicines and provide CHW compensation based on a priori defined performance indicators thresholds. Data collected using the applications will be visualized on a real-time basis. This will enhance the Kisumu County and Sub County Health Management Team’s ability (SCHMT) to make decisions based on data. LG and Kisumu County plan to embed an evaluation to assess the impact and cost effectiveness of the program as well as best practices, and insights for decision making.

In addition, Living Goods is working nationally alongside the Government of Kenya and its partners to develop and operationalize an electronic community health information system (eCHIS) as part of health sector reforms to achieve UHC and enhance data use at all levels. Having supported the Kenya MOH to successfully pilot integration of community-level data into KHIS in 2019, Living Goods is the lead technical support partner on performance management, M&E, data use and wraparound services. Kisumu County is one of the pilot counties to roll out the new eCHIS system and improve health outcomes by leveraging digitally empowered CHWs to ensure the seamless flow of reliable and timely data from the community to the national level.

Section II: Purpose and Objective of the Evaluation

The aim is to evaluate the implementation of a DESC-enabled community health worker program, including impact on RMNCH outcomes. The evaluation should include process evaluation, impact evaluation and economic evaluation components.

The specific research objectives are:

• To measure changes in maternal and child health outcomes
• To determine changes in utilization of maternal and child community health services.
• To determine the changes in health seeking behaviour of caregivers of under-5 for iCCM and women for maternal health services.
• To assess the cost effectiveness of the DESC-enabled community health program
• To assess the process of implementation and the transferability of the findings to other settings, including other counties of Kenya due to political, health system, and epidemiological variation
• To identify challenges and best practices in implementing DESC community health and providing sustainable technical assistance to counties in Kenya

Section III: Scope of Research Design, Timelines, Deliverables and Budget

Study Design and Sampling

Living Goods and the County Government of Kisumu plan to implement a phased DESC-enabled community health program in Kisumu County. Here, all CHWs from systematically selected community units (CUs) will be trained and enrolled into the DESC community program at predefined timepoints and with clear roles and responsibilities.

We plan to embed a research evaluation alongside implementation of the program to enable the development of robust evidence to guide scaling to similar counties in Kenya and beyond. The consultants are therefore requested to define a study with a clear counterfactual and that accounts for the phased program implementation. We anticipate data collection (including use of routine HMIS data, qualitative data, and household surveys) at three-time points; baseline, midline (month 12) and endline (month 24). In addition to the quantitative data collection, the surveys should examine health seeking behaviors, DESC implementation challenges, barriers faced in utilization of health services and utilization of CHW services by the community. At minimum, the proposed study should include household surveys, economic evaluation, and a health system assessment. Where direct measurements cannot be made, the consultants should propose how this data can be modeled or estimated. The rigor and quality of the research should make it eligible for publication in a peer-reviewed journal.

The research consultants are expected to prepare a detailed proposal for Living Goods’ review including a robust study design to rigorously assess the impact of the DESC community health program across the county. The proposal should explain the rationale for the design, the sampling strategy and sample size calculations to be used. In addition, the criteria for evaluation will examine the robustness of the relevant experience, logical presentation, and cost alongside the technical evaluation.

Deliverables

• Study Protocol Development (in collaboration with LG and Kisumu County co-investigators)
• Develop study aims, research questions and objectives.
• Develop the study methodology.
• Support the systematic selection of areas for programme and research sites including making recommendations on inclusion and exclusion criteria.
• Develop the data collection tools, quality monitoring and control SOPs, and data collection approaches.
• Develop a data analysis plan.
• Ethical Review and Approval
• The research consultant will be responsible for designing and seeking ethical approval from a Kenya-approved ethical review board and approval from the National Commission for Science, Technology and Innovation (NACOSTI).
• Design of validation approaches
• Test the quantitative and qualitative data collection tools.
• Develop a data audit and feedback mechanisms to ensure high quality data capture and continued improvement.
• Data collection
• Recruit and contract research assistants as needed
• Develop a data collection methodology and tool training guide for research assistants.
• Train the research assistants on data collection and protocols.
• Develop a work plan for data collection according to the methodology prescribed.
• Monitor and support quality control during data collection.
• Data analysis and reports
• Baseline, mideline and endline report that includes analysis and insights from process, impact, and economic evaluations
• Draft publication manuscripts and policy briefs
• Dissemination, documentation, and publication
• Support in dissemination and buy-in from relevant stakeholders, including baseline/midline/endling meetings with County and sub-county HMTs
• Participation in a ‘learning event’ for other sub-counties at midline
• Lead and contribute to peer-review publications and other research outputs for advocacy such as policy briefs.

Resources

• Report on program data, data use, data quality, program review and reporting at Living Goods.
• Other relevant documents and data.

Project Management, Stakeholders & Reporting

Reporting will consist of bi-weekly calls with relevant LG and Kisumu County team members on progress and for collaborative development of tools and use of results in the submitted proposal; we are a team that values communication and we have a culture of data use, so look forward to improving our intervention over time with your inputs.

Timelines

The entire activity after proposal approval is estimated to take 3 years (36 months) including Protocol development, ethical review, baseline, midline, and end line data collection, data analyses, development of research outputs and dissemination. The baseline survey is expected be conducted latest December 2021.

BUDGET AND PAYMENT

Although the protocol description should include the entire study design, we will initially contract for the baseline survey. Therefore, please provide a complete budget with distinct estimates for the baseline, midline and end line separately. The service provider should demonstrate interest to run the study to completion. Payments will be milestone-based and linked to the project deliverables. All milestone deliverables must be confirmed in writing via email by the service provider to the delegated LG Senior Program Manager for approval and release of payment by finance.

Section III: Proposal Evaluation Criteria

The following is a list of significant criteria against which proposals will be assessed (percentage weight):

• Demonstrated experience of consultant and key project staff in relevant in health systems strengthening, MNCH, community health and program evaluations, including published studies (30%)
• Demonstrated experience of consultant and key project staff in partnering closely with government in designing, conducting, and applying evidence from research. (20%).
• Appropriateness and rigor of proposed methodology (20%).
• Reasonableness and adequacy of budget (20%).
• Quality and clarity of proposal (10%).

Section IV: Instructions and Deadlines for Responding

• Please submit one soft copy (by email) in PDF format to , CCing ; and pmogeni@livinggoods.org not later than 15th September 2021
• Proposals should be submitted as one file, not exceeding 5MB in size.
• Proposals must include:
  • Health research capacity statement for the research firm, key personnel (Health Systems researcher, statistician with expertise in study design for evaluation of complex interventions, and health economist), proven health research experience attested by a portfolio of publications/reports in impact evaluation, implementation and cost effectiveness research, CV(s) of key personnel working on the study as well as relevant references.
  • Technical proposal (5 pages max).
  • Workplan specifying milestones towards key deliverables.
  • High-level budget for baseline implementation based on proposed evaluation design.
  • Consultancy budget including daily rates of key personnel.
• Note: a) Living Goods (LG) and Kisumu County government will participate and collaborate with the selected consultant on baseline budget discussion and IRB submission. b) This is a strategic evaluation study that aims to develop evidence for decision making and sustainability. We therefore emphasize on a strong research team that will not only deliver high-quality data but also be able to deliver high-impact peer-reviewed publications and other research outputs. c) Applications will be reviewed on a rolling basis.
  
  Section VI: Terms and Conditions of the Solicitation
  • Misrepresentation. LG’s decision-making process will largely rely on the information supplied by bidder. Should it be found that aspects of such information are incomplete, untrue, or misleading, LG reserves the right to terminate /disqualify the bidder.
  • Notice of Non-binding Solicitation. LG reserves the right to reject any or all applications received in response to this solicitation and is in no way bound to accept any technical application.
  • Confidentiality. All information provided by LG as a part of this solicitation must be treated as confidential. If any information is inappropriately released, LG will seek appropriate legal remedies as applicable.
  • Evaluation of Bids. Evaluation of bids submitted pursuant to this RFP will be carried out by LG as appropriate. In evaluating bids, LG will seek best value for money rather than merely the lowest price bid. LG reserves the right to do partial awards.
  • Conflict of Interest Disclosure. Supplier bidding on LG business must disclose to the procurement team at LG any actual or potential conflicts of interest.
  • Amendments. If at any time prior to award LG deems there is a need for a significant modification to the terms and conditions of this RFP, LG will issue such a modification as a written RFP amendment to all competing bidders. No oral statement of any person shall in any manner be deemed to modify or otherwise affect any RFP term or condition, and no bidder shall reply on any such statement. Upon release of this RFP, all bidder communications concerning this RFP should be directed to the RFP requestor. Unauthorized contact regarding this RFP with other LG employees may result in disqualification
  • Post-Tender and Iterative Negotiation. LG reserves the right, in its sole discretion, to conduct post tender and/or iterative negotiations to the extent necessary.
  • Extension of Bid Validity Dates. When necessary and appropriate under the circumstances, LG may request bidders in writing to extend the validity period of the bids. A bidder may refuse to extend its bid however its bid will be disqualified.
  • Rejection or Award.
    • LG is not bound to accept the lowest price and reserves the right to accept any bid in a whole or in part and to reject any or all tenders without disclosing reasons for taking of the decision resulting from this RFP. In the event that this contract is split, the pricing offered in the bid is expected to be maintained. Should there be pricing differences in line with business awarded, it must be clearly stated in your proposal
    • Rejection may be initiated by the following circumstances: (i) None of the bids are adequately responsive to the specifications, (ii) there is evidence of insufficient competition, or (iii) the lowest bid exceeds the estimated value or funds available by a significant amount and cannot be reduced by negotiation etc.
    • All awards are subject to availability of adequate funds from LG and the receipt of all required approvals from donors.
    • LG will officially notify all successful and unsuccessful bidders.