Country: Somalia
Closing date: 19 Jun 2015
The United Nations Office for Project Services (UNOPS) has been engaged by the Ministry of Health of the Federal Government of Somalia to provide technical assistance in seeking qualified offers for the above-mentioned Request for Proposal (RFP). Your organization is kindly invited to submit your best technical and budget offer for the requested services. Your proposal could form the basis for a Grant Support Agreement (GSA) between your organization and the United Nations Office for Project Services (UNOPS).
BACKGROUND
Health context\*[1]*
The health of the people of Somalia remains in a critical situation with some of the worst health indicators in the world. On-going insecurity, lack of government access and limited coverage of health care services across most of the regions of Somalia is resulting in high levels of ill-health and frequent disease outbreaks.
There is a severe shortage of qualified health staff of all disciplines. Coverage of public health services in rural areas, and for nomadic populations, is very limited. Immunisation rates remain low and a skilled provider attends fewer than 20% of births. Current confidence in, and access to, the health system is very low.
By far the majority of ill people, if they can afford and access it, secure treatment from the unregulated private sector. There is a growing commercial health care service sector, mostly providing diagnostics and pharmaceuticals. The quality of care provided by private providers is variable and often poor. Private providers are concentrated in the major urban areas, resulting in great disparity in access to healthcare between towns and rural areas.
Nominally, the government provides health services through a four-tiered system – Regional hospitals, Referral Health Centres; Health Centres and Primary Health Units all providing at least some elements of a package of preventive and curative services known as the EPHS. Most services comprise of basic primary health care and outpatient services, and cater to women and children. Public sector service points are often managed, financed and at least partially staffed by employees of international or national NGOs and CBOs.
Information for planning and management is scarce, of uneven quality and incomplete. A health management information system (HMIS) collects some basic information on service statistics (mainly activity/diagnosis) from some health facilities. HMIS data are currently not used in planning.
External support is the mainstay of financing of the public health sector. In South Central Somalia emergency assistance absorbs a considerable proportion of donor assistance; other disease specific programmes, such as those for polio eradication, malaria and HIV/AIDS are also the currently receiving a high proportion of funds.
As security across South Central Somalia is now improving and more areas are coming under government control, attention is now being given to transitioning the chronic/post-conflict health system from one that focuses on responding to emergencies to one that responds to peoples’ everyday health needs.
In terms of Service Delivery, the strategy of the Ministry of Health is to “*Roll out the provision of equitable health services and functional health facilities in all regions*”.
To implement this strategy the Ministry of Health will award contracts to international or national private sector organizations to manage the roll-out implementation of the EPHS. Contracts will include contractual obligations linked to M&E, reporting and coordination.
In order to ensure that existing external actors are contributing to the strategies in the plan, the Ministry of Health will develop and agree memoranda of understanding (MOU) with NGOs that are already supporting basic health services and the EPHS. These will include an agreement to provide the standard EPHS core programmes, use the agreed remuneration package, and adhere to common systems of reporting.
De Martino Hospital
De Martino, in Mogadishu, was built by the Italian Government in 1910 and has not been operational since the collapse of Siad Barre in 1991. The structure was in very bad shape and there are currently no health services provisions in the hospital.
The United Nations Office for Project Services (UNOPS) received an Italian contribution aiming at reopening of De Martino Hospital by rehabilitating part of the hospital infrastructures and by the procurement and installation of furniture and main medical and non medical equipment.
The hospital is composed of the following Units/ Departments:
· Emergency Unit with an Operating Theatre and rooms for triage, stabilization and observation of patients
· Maternity Unit with One delivery room rooms and a 20 bed ward
· Surgical Unit with an Operating Theatre (with the related ancillary services: Recovery Room, Changing Area, Sterilization Room, etc.) and a 20 bed ward for admission.
· General Outpatient Department (OPD) composed of a registration/ waiting area, four visiting rooms, medication room, injection room, a pharmacy, a laboratory and an X-Ray Unit.
· Ancillary Departments – Laundry, morgue, water treatment, generator.
OBJECTIVE
The intervention aims at contributing to the improvement of the health status of the population living in Mogadishu by supporting De Martino Hospital in providing quality diagnostic and curative health services.
EXPECTED RESULTS
The ultimate purpose of the intervention is the provision of efficient and effective health services able to meet the health needs of the beneficiary population. Since the quality of the health services ultimately depends on the presence of skilled managerial/ clinical staff and adequate infrastructures, equipment and supply, the implementing organization is expected to put in place the relevant standards, tools and procedures for the following managerial/ clinical components:
· Hospital Management Structures –Establish and organize the work of a Hospital Management Team (HMT), composed by the hospital senior managers, who will be responsible for the daily management of the hospital activities (provision of care, administration, financial and HR management).
· Human Resources Management System -Develop an appropriate management system addressing the key components of the Human Resources function, including: i) estimation of staffing needs; ii) staff selection and recruitment; iii) development of personnel policies (work schedule, job descriptions, SOPs, compensation, performance evaluation procedures, etc.). Also, the skills and competencies of the recruited staff should be assessed and relevant orientation and training programs for hospital’s employees developed and conducted.
· Asset management – Create and maintain an inventory of the physical assets of the hospital, establish a maintenance system, manage procurement and utilization of medical and non-medical consumables.
· Financial and Accounting management system – The system should be able to provide sound financial information on sources and levels of income and on costs incurred in delivering the services. This information will assist planning for recurrent budgets and to inform pricing of services, increasing transparency, accountability, and efficiency.
· Quality of care –The hospital will strive to provide the best quality of care possible. To this end it should make use of strategies and tools for monitoring and improving the quality of health services provided by systematically reviewing the care provided against set criteria (clinical audit). Development of standard clinical protocols and appropriate patients’ documentation (medical records) are prerequisites in order to evaluate quality of care. As already mentioned under the HR management component, it is important to ensure an adequate professional capacity of the health personnel. To this regard, the proposal should identify possible training resources and describe the implementation methodologies of the training activities.
· Health Information Management System (HMIS) - The hospital will make use of the standard formats for monthly reporting of morbidity/ mortality and service data, endorsed by the local health authorities. Monthly HMIS reports will be submitted to the Health Authorities and to UNOPS.
· Monitoring and Evaluation - Definition of tools and procedures for monitoring and evaluation of hospital activities (analysis, interpretation and use of the data provided by the different information systems, identification of performance and quality indicators, etc.)
ALLOCATION OF GRANTS
UNOPS will award grants to international and national non-for-profit organizations to support the implementation of a defined package of health services to be delivered by De Martino Hospital in Mogadishu.
Due to the complexity of the intervention, the applicant may want to consider partnering with other organizations that can provide specific added values to the action and facilitate its implementation.
Applicants are requested to prepare a proposal for 24 months duration, according the following outline. Note that the grant support agreement will be initially signed only for the first year of implementation and might be extended for an additional 12 month period upon satisfactory performance of the grantee year and availability of funds.
Applicants are furthermore expected to provide a written acceptance of the grant within 10 days from the communication of the successful award of the grant and sign the contract within 2 weeks, failure to which the contract will be nullified.
OUTLINE OF THE PROPOSAL
Technical component
Summary\*(Maximum 1 page)*
Applicant operational capacity\*(Maximum 3 pages)*
· Provide a list of health intervention your organization(s) has managed globally and annex the organizational chart of the team responsible for coordinating the activities under this grant (element 1.1 of the evaluation grid)
· Describe current and previous experiences of the organization(s) in managing health services in Countries in complex emergencies (1.2)
· (For further elements for evaluating of the applicant operational capacity see annexes)
Objectives and Expected results\*(Max 6 pages)*
· Provide a list of the services expected to be delivered by the hospital, detailing the content of each service and delivery modalities (i.e. management of obstetric complications; management of medical and surgical emergencies, services available 24/7, etc.) (2.1)
· Describe the clinical and managerial standards/ tools to be adopted. The implementing organization is expected to adhere to common clinical and managerial standards endorsed by the local health authorities (EPHS, HMIS, staffing patterns, salary scale, etc.) or to develop/ adopt new ones in case the official ones do not exist (2.2)
Detailed description of activities\*(Max 3 pages)*
· Describe each activity to be undertaken to produce the results, justifying the choice of the activities and specifying where applicable the role of each partner in the activities (2.3)
Methodology\*(Maximum 7 pages)*
· Specify where applicable the role of each partner in the action. Outline the team proposed for implementation of the action by function. Describe qualifications and tasks foreseen for each member of the management staff. Please note that upon allocation of grants, the applicant must provide the CV of each of the proposed senior team members (3.1)
· Describe the physical resources required for the implementation of the action (equipment, consumables, running costs, etc.). Justify the need for the required resources (3.2)
· Describe tools and procedures to be used for follow up and for internal/external monitoring and evaluation (3.3)
· Describe mechanisms and procedures used in order to ensure collaboration and cooperation with the local Authorities, health partners and local communities. Particular attention should be given the war veterans living in the proximity of the hospital, identifying options for including them in the running of the hospital (3.4)
· Describe the activities planned to guarantee adequate visibility to the contribution of the donor (Italian Government) (3.5)
Action plan and Time frame(3.6)
Logical framework
Annexes
· Organizational chart of the team responsible for the intervention (1.1)
· Curriculum vitae of the person responsible for coordinating the activities under this grant (1.2)
· Audited accounts for the last three years of operation (1.4)
Budget component
The project aims at providing support to De Martino Hospital in delivering health services, integrating the funds already available to the applicant organization.
The applicant is requested to prepare a budget for the overall action detailing and quantifying the sources of funding (in cash or kind) provided by the applicant, his partners or other sources (including eventually revenues deriving from user fees) in support of the hospital, identifying the components with funding gaps for which support is requested to UNOPS. A cash flow projection for a 24 month period should be included (4.1 and 4.2)
The applicant is also requested to prepare an exit strategy for the 12 months following the termination of the contract, explaining how the hospital will be able to meet the managerial and financial requirements for continuing the provision of health services following the termination of the present intervention (4.3)
Eligible costs
· Salaries/ incentives for local staff (not exceeding 40% of the overall budget)
· Salaries for international/ expatriate staff attached to the project and eventual consultancy fees (not exceeding 20% of the overall budget)
· International and local transportation costs
· Drugs and medical consumables (including also X-ray and laboratory consumables) Hospital running costs (utilities, fuel for generator/vehicles, maintenance, etc.) plus other relevant costs such as communication, visibility and printing costs, costs in relation to workshops and/or training courses (rental of facilities and equipment, production of material, catering and other costs in relation to participants) and other specific inputs required to carry out the project
· Overheads (up to 7% of eligible costs)
[1] Excerpted from: Health Sector Strategic Plan January 2013 – December 2016. The Federal Government of Somali Republic, Ministry of Human Development and Public Services, Directorate of Health
How to apply:
Please visit UNOPS Website http://https//www.unops.org/english/Opportunities/suppliers/Pages/Grant-advertisement.aspx to access CFP documents.
When to submit?
·Date: 19th June 2015
·Time: 10am (Kenyan Time)
·Where to submit?
By email to secure email address:keoh.cfp@unops.org
*Questions can be directed to Renato Correggia MD, Project Manager, UNOPS EAH,Email:*RenatoC@unops.org