REQUEST FOR EXPRESSIONS OF INTEREST

(CONSULTING SERVICES – FIRMS SELECTION)

 

Country:                   Republic of Uzbekistan

Project name:         Integrated Perinatal Care Project (IPCP)  

Loan No.:                 52340-001-UZB

Assignment Title: Baseline and Endline Surveys.

Reference No.:       CS-04

 

1. The Ministry of Health of Uzbekistan - MoH (hereinafter called “Client”) has applied for financing from the Asian Development Bank (the “Bank”) in the form of a loan toward the cost of the Integrated Perinatal Care Project. The Client now intends to apply a portion of the proceeds of this loan to eligible payments for consulting services.

 

1. A firm will be selected under Consultants Qualifications Selection (CQS) procedures using a Biodata Technical Proposal (BTP), in accordance with the policies of the Bank detailed in the 2017 ADB Procurement Policy and 2017 Procurement Regulations for ADB Borrowers, which can be found at the following website:

https://www.adb.org/documents/adb-procurement-policy; https://www.adb.org/documents/procurement-regulations-adb-borrowers.

 

1. The detailed Terms of Reference (TOR) for the assignment is given below:

 

BASELINE AND ENDLINE SURVEYS

 

I. Background

The Integrated Perinatal Care Project (IPCP) supports the government’s commitment to achieving the Sustainable Development Goals (SDGs), in which perinatal health has become a main priority area of the government policy. The project addresses identified needs in perinatal health, namely regionalization of perinatal care by strengthening care and treatment capacities at each level of care.  It aims to improve the quality of perinatal services in the country and has four outputs:  

Output 1: Perinatal centers modernized and upgraded. The project will provide about 230 perinatal centers throughout Uzbekistan with high-quality and energy-efficient medical equipment. The equipment provisions will replace worn-out and outdated equipment and support the planned increase in number of maternity beds, NICUs, and functional operating theaters. To help ensure reliability and sustainability of the project equipment, suppliers of essential equipment will be required to provide post-warranty comprehensive maintenance services for at least 2 years. Proper inventory, functioning, and maintenance of medical equipment will be recorded and monitored through an asset management system being developed by the government. Capacity building under the project will ensure that knowledge about corrective and preventive maintenance will be transferred to local levels.

Output 2: Perinatal referral system strengthened. To ensure access to timely and quality risk-appropriate care of pregnant women and newborns, the project will enhance the perinatal referral system through further assessment and strengthening of current implementation gaps, including capacity building of emergency response teams. It will support the national rollout of EHRs—that would allow intra- and inter- facility sharing of patient information — to strengthen efficiency and effectiveness of the perinatal referral and counter-referral system. Patronage nurses, attached to district antenatal clinics, will be equipped with digital tablets and provided with access to the EHRs to register and track pregnant women in their catchment areas.

Output 3: Quality adherence at perinatal centers enhanced. The project will enhance continuous medical and professional education through support for developing and updating relevant training curricula and modules aligned with international standards. Training on supportive supervision—emphasizing mentorship, joint problem solving, and two-way communication between supervisors and supervisees will be provided to support ongoing government efforts to improve monitoring the quality of care. Health workers will be trained to recognize and provide services to victims of gender-based violence, as well as on managing health risks to pregnancy women and newborns associated with climate change. Quality adherence including monitoring compliance with clinical pathways and referral protocols and establishing quality committees in health facilities will further improve the quality of care of perinatal care.

Output 4: Maternal health-seeking behavior improved. The project will support interventions to improve maternal health-seeking behavior and help women receive timely and appropriate care. Targeted media campaigns will inform and influence women and families about the importance of antenatal care, focusing on empowering young women. It will also support (i) developing knowledge and capacity of midwives and nurses in social and behavior change communication (BCC), in line with the implementation of the universal-progressive model of home-visiting nurses, (ii) assignment of BCC focal persons in higher-level perinatal facilities, and (iii) sensitizing and engaging policy makers regarding the importance of perinatal health.

II. Survey objectives

The consult firm will support the PIU to design and conduct the project baseline and endline surveys. 

Baseline survey. The survey will establish the baseline situation for subsequent assessment of project outcome and achievements, including in terms of improving utilization, quality of services including referrals, and maternal health seeking behaviors. The survey will establish baseline values for the indicators in the design and monitoring framework (DMF) and gender action plan (GAP). The firm will develop survey methodology (consisting of both quantitative and qualitative methods), survey tools, and sampling approach in consultation with the EA/PIU.

Endline survey. The endline survey will assess the before-after achievements of the project as measured by, among others, the project indicators in DMF and GAP. The survey will provide endline estimates for project indicators in terms of implementation outcome and outputs and measure changes in all DMF’s indicators.  The endline survey may also include additional questions to evaluate the project design and implementation issues and lessons.

III. Scope of work

A firm is sought to carry out the baseline and project completion surveys. The work will include: further consideration and finalization of the sampling design; finalization of the data collection methodology; development, pre-testing and finalization of the data collection tools: preparation of the data collection schedule; and carrying out data collection, data analysis and report writing. The Firm is also expected to provide relevant data analysis software and equipment such as tablets.

General tasks under the assignment include the following:

• Review all project documents
• Undertake consultations with PIU to confirm the scope of work
• Design overall survey methodology for review and approval of the PIU
• Based on the approved methodology, develop the evaluation tools and detailed implementation plan.
• Undertake field data collection, data processing and analysis.
• Prepare draft reports and recommendations for review by the PIU/EA and ADB
• Finalize report based on feedback.

IV. Survey methodology

Sampling design

The surveys at baseline and for project completion will require a sample of 80 Perinatal centers (PC), 720 women from the communities and 400 Staff members of perinatal centers. Parameter values used to calculate these sample size requirements are presented in Table 1.

Table 1. Required sample sizes and parameter values used for sample size calculation for Perinatal centers (for one wave of study. There are two waves in total).

	For Output 1, 2, 3		For Output 4
	Perinatal centers	Staff of perinatal centers	Household survey of women
Final sample size	80	400	720
Parameters used
Level of confidence (Z)	95%	95%	95%
Margin of error (d)	8,5%	5%	5%
Baseline level of the indicators (P)	50%	50%	50%
Design effect (DEFF)	1.0	1.0	1.5
Anticipated non-response rate (R)	0%	0,5	20%
Finite population correction (FPC)	Applied	Not applied	Not applied
Calculated required sample size	80	383	692
Number of respondents from each Perinatal centers	-	4,8	8,6
Rounded number of respondents from each Perinatal centers	-	5	9

 

 

The formula used to calculate the required sample size is:

 

The formula used for finite population correction is:

 

where N is the total population size and n is the calculated sample size.

The surveys will be carried out through a multi-stage probability sampling design. At the first stage, PCs will be proportionately drawn from the 14 regions of Uzbekistan. Thus, the number of PCs to be drawn from each region will be in proportion to the region’s total number of PCs. In sampling PCs in each region, the probability proportional to size sampling method will be applied since the catchment area population size varies across PCs. By doing so, PCs with larger catchment area population sizes will have the same probability of being selected as those with smaller ones. The list of the PCs and information on PC population catchment sizes will be obtained from the Ministry of Health (MOH). A total of 80 PCs will be sampled across the 14 regions.

For the baseline survey and to complete the project, a sample of 400 staff from the perinatal centers included in the project will be required.

In each medical institution, 5 employees will be randomly selected to occupy various positions.

At the next stage, one mahalla will be selected for each RFP sampled. The list of mahallas under each RFP as well as the latest population size per mahalla will be obtained from the MOH. Selection of mahallas will be done through probability proportional to size sampling technique so that every mahalla under each RFP will have an equal chance of selection. A total of 80 mahallas will be included in the survey.

In each selected mahalla, nine households will be selected through simple random sampling. In each selected household, one woman of reproductive age will be interviewed. Through this sampling design, a total of 720 women are expected to be included in the survey. Pregnant women living in the sampled households will also be included in the survey. In cases where there will be more than one woman in the sampled household, simple random sampling will be applied to include only one of the women in the survey.

The baseline and project completion surveys will be conducted in the same mahallas. Households for each study will be selected independently using a random sampling method, ensuring that each study has its own distinct sample.

Data collection methods

Data collection at baseline and project completion will be conducted using both quantitative and qualitative methodologies.

Quantitative methods will involve surveying representatives of the administration and healthcare workers of perinatal centers, as well as women residing in mahallas (including pregnant women).

While conducting interviews, it is recommended to use CAPI tablets with GPS functionality enabled. Survey metadata and geocoordinates should be systematically collected for each interview, including the time, date, location, and duration of the interview.

Focus group discussions (FGDs) will be conducted with two categories of respondents:

•  Healthcare workers from perinatal centers
•  Pregnant women affiliated with the selected perinatal centers

It is expected that each region will host one FGD for each of the aforementioned respondent categories. Consequently, the study will encompass a total of 14 FGDs with healthcare specialists and 14 FGDs with pregnant women.

In each oblast, one PC will be randomly selected from the list of PCs already selected to be surveyed. The FGDs will be conducted in the catchment area of this randomly selected PC. Each FGD will comprise of 8-10 participants to be facilitated by a trained moderator and assisted by a trained transcriber.

A facility assessment will be conducted at project completion to determine the proportion of PCs with readiness to provide services. This will require direct observation of the availability of functional equipment and basic facility amenities as well as interview with key RFP facility staff. Selected spot checks on availability and use of equipment and instruments procured under the project will be carried out.

The Firm shall assign to each data collectors the houses and facilities to visit and respondents to interview. The Firm shall put in place a system for supervision and questionnaire checks in the field during data collection to ensure timely and quality collection of data.

V. Development of data collection tools and ethical clearance

Different data collection tools need to be developed to collect data for the main and supplementary survey variables. The Firm is expected to develop a more exhaustive variable list with their operational definitions as well as formulate the appropriate questions for a comprehensive survey tools. The Firm is expected to review existing and, if available, planned survey tools in Uzbekistan, to ensure that questions on sociodemographic information, health and other indicators are phrased consistently. The data collection tools will be available in paper and electronic formats. The electronic format, to be installed in tablets, shall have built-in features such as required field entries, skip features, and response code range limits to facilitate data completeness and limit data entry errors. The data collection tools will also be available in English, Russian and Uzbek languages.

The data collection tools must include informed consent forms. The PIU will be required to seek ethical clearance from the Ethical Committee of Uzbekistan’s MOH.

VI. Pre-testing and finalization of the data collection instruments

Prior to finalization, all survey data collection tools will be pre-tested to ensure that the questions are properly worded and logically sequenced, and that the data collection forms are appropriately formatted with correct skip instructions. The pre-test will also be used to refine potential responses for closed-ended questions and ensure the questions are understood consistently by respondents.

VII. Selection and training of data collectors and supervisors

The appropriate number of survey data collectors and supervisors  will be hired according to the required academic background and work experience. The hired data collectors will be trained on the proper administration of the data collection tools as well as on ensuring respondents’ privacy and data confidentiality. The field supervisors will be responsible for the smooth implementation of the data collection in the field and for performing quality checks on the data collected. A data collector’s manual will be developed to provide the data collectors with the guidelines on how to properly administer the data collection tools, record the answers, perform data checks at the end of the respondent interview and facility visit, and how to properly secure the accomplished data collection tools.

VIII. Preparation of the detailed schedule for data collection

Based on the agreed sampling design, the Firm shall develop an efficient data collection schedule based on careful consideration of the sample size to be covered, the number of data collectors and the overall survey timeline.

 

IX. Data processing and analysis using appropriate statistical programs (for baseline and project completion surveys)

The Firm shall develop a data processing (from data coding, consistency checks, cleaning and validation) and analysis plan. The plan will be designed to clearly address the surveys objectives and shall detail how the data for the main indicators of the surveys will be processed as appropriate. It shall also detail how results of the baseline and project completion surveys will be compared under survey objective. The plan shall also provide dummy tables and graphs.

Data processing and analysis shall be carried out as agreed in the data processing and analysis plan. Appropriate statistical software is expected to be used and to be provided by the Firm. In addition, necessary graphs and charts will be produced and included in the analysis.

X. Preparation of an analytical report (for baseline and project completion surveys)

The Firm shall prepare an analytical report summarizing the survey methodology that was used, the main results and their interpretations, conclusions and set of recommendations. Necessary graphs and charts will be produced and included in the analysis.

XI. Expected outputs

1. Reviewed sample size and sampling design for the baseline and project completion surveys (during the 1st Baseline Survey/ 7th Project Completion Survey month).

2. Detailed implementation plan (during the 1st Baseline Survey / 7th Project Completion Survey month).

3. Draft and final data collection tools (questionnaires) and methodology for baseline survey and project completion surveys (during the 2nd Baseline Survey / 8th Project Completion Survey month).

4. Clean survey database with manual of the data codes used (during the 4nd Baseline Survey / 10th Project Completion Survey month).

5. Draft and final analytical report for baseline survey (during the 6 Baseline Survey months).

6. Draft and final analytical report for project completion surveys (during the 12th Project Completion Survey month).

7. Presentation slide deck and summary of results (during the 12th Project Completion Survey month).

XII. Organization of work process

The Firm will perform the work jointly with the PIU.

In the process of work, the Firm will conduct meetings with the Project staff and consultants and with the Expert Committee of the MOH (composed of the Head of the Departments of the MOH) to discuss and agree on the final sampling design, data collection tools, schedule of data collection, list of data collectors, data processing and analysis plan, and the analytical report.  All activities will be conducted according to the schedule agreed with the MOH and the ADB.

The PIU will be required to seek ethical clearance from the Ethical Committee of Uzbekistan’s MOH. The data collected from respondents will be treated in a confidential manner throughout the entire process of data collection, coding and analysis, as well as record keeping both in electronic or paper forms. Specific personal information will be removed from all electronic media used by the research management team during data analysis process.

XIII. Reporting

The Firm will report to the PIU “Integrated Perinatal Care Project”.  The Firm shall turn over all survey materials to the Project staff: final data collection instruments, survey database, and manuals. As the work proceeds, the Firm will provide technical reports to the Project on the work performed in Russian and English in accordance with the sections XIV “Consultant Reporting Obligations” of this ToR. The final report will be submitted to the PIU in Russian and English.

XIV. Qualifications of Consulting Firm, Key and Non-key Experts

The firm shall have at least 10 years of experience conducting similar scope of work, including experience in evaluation of health sector interventions. The Firm should be well experienced with design of quantitative and qualitative surveys including sampling and developing survey data collection tools and indicators to assess population health status and health seeking behaviors. The Firm should be experienced in organizing and conducting trainings, developing electronic formats for data collection, use of tablets for electronic data capture, data processing and analysis using statistical programs (SPSS, STATA, EPI INFO, etc.), evaluating quality of collected data, and in writing analytical reports.

Preference will be given to a Firm experienced in conducting similar surveys in Uzbekistan. The Firm should provide a team of national experts with appropriate qualification and experience in the field of each specified areas of the survey (higher education, background in conducting of sociological surveys, excellent communication and writing skills in Uzbek and Russian languages, ability to move in the project sites, etc.). Minimum qualification requirements for specialists are listed below. The Firm can offer alternative specialists if deemed more appropriate to the survey needs.

Key Experts

1. Principal investigator (Team Leader)

• Main responsibility: overall design and management of the surveys and ensure that the methodology and tools are sound; the data collection, processing and analysis are timely; and that the outputs are of high quality. Lead preparation of survey reports.
• University degree in a field of social science (health system research, sociology or another relevant field).
• At least 10 years of experience in overseeing national surveys and managing survey teams and delivering survey outputs and reports in a timely manner.
• Good computer skills (Excel, Word, Power Point, e-mail)
• Good communication and analytical skills.

 

1. Public health specialist (Deputy Team Leader)

• Main responsibility: provide guidance in development of survey methodology, the identification of the variables, operationally define the variables related to the first and second survey objectives, develop the questionnaires and develop manual, provide guidance in the data processing and in the interpretation of the results, and contribute to the writing of the final report.
• University degree in a field of public health (or another relevant field).
• At least 10 years of experience in health research, including developing survey methodology and tools, questionnaire contents and in conducting studies that evaluate the impact of public policies, social programs and/or measures on specific groups of the population.
• Experience in quantitative and qualitative research methods
• Experience and skills in preparation of analytical reports.
• Good computer skills (Excel, Word, Power Point, e-mail)
• Familiarity with statistical software (STATA, SPSS, etc.)

 

1.  Specialist in biostatistics/ data management

• Main responsibility: develop sampling design and calculate required sample size, developing data entry tool, processing and managing survey data, ensuring data quality, calculate of sampling weights, perform data cleaning and analysis, and develop statistical tables and graphs
• University degree in statistics, sociology, or related fields
• At least 5 years of experience in developing study design, data management and analysis, sampling methodologies (design and sample size), developing data entry interfaces, processing survey data, calculation of sampling weights, descriptive and regression data analysis using statistical programs such as (SPSS, STATA, Epi Info or similar programs)
• Good communication skills and ability to work in a team

Non-Key Experts

The firm shall determine the composition of non-key personnel to support the assignment. This may include field survey supervisors, enumerators, and data-entry clerks, based on the methodology proposed by the Firm. The CVs of non-key staff will not be individually scored; however, the project implementation unit (PIU) will review and individually approve or reject each CV.

Example of non-key experts and criteria:

1. Field survey supervisor

• University degree
• At least 10 years of experience in training data collectors, supervising data collectors in the field, perform data checks in the field, managing data collection schedules, and in interviewing adult respondents
• Ability to move between households of regions and facilities
• Good communication, leadership and organizational skills, and ability to work in a team
• Knowledge of Uzbek and Russian languages is obligatory

1. FGD moderator

• University degree
• At least 10 years of experience in developing FGD guides, moderating FGDs, and analyzing and reporting FGD results
• Good communication, leadership and organizational skills, and ability to work in a team
• Knowledge of Uzbek and Russian languages is obligatory

1. Data collectors/transcribers

• Main responsibility: collection of the data in the field
• Higher or secondary special education
• Preferably with experience with data collection in the field
• Ability to move between households of regions and facilities
• Knowledge of Uzbek and Russian languages is obligatory

1. IT specialist /Computer programmer

• University degree in IT specialist (in the field of information systems, databases, monitoring and evaluation, programming)
• Experience in development and implementation of information systems databases
• Knowledge of the hardware and software, computer networks, e-mail and the Internet, working with MS Word, Exсel, Power Point applications.

XV. Primary data verification

After completion of data collection, the interviewer fills out a special form that reflects the number of interviewed respondents and certifies it with the responsible representative of the RFP.

XVI. Project contribution

The project will provide communication and cooperation with stakeholders, as well as establish the working group of MOH, the main task of which is to assist in the development of survey tools and interpretation of findings. The Project will provide the Firm with available reports, regulatory documents, and other information required for the assignment.

All reference materials and data sources will be provided to the Firm for temporary use and shall be returned to the Project upon the completion of the assignment or earlier upon request.

XVII. Company contribution

The Firm should include in its proposals the required staff that should be hired and paid by the Firm itself.

The Firm should have its own computer equipment and standard software (SPSS, STATA, EPI INFO, etc.) for data processing and statistical analysis.

XVIII. Service period

Twelve (12) months according to Preliminary Survey Work Plan. If necessary and in agreement with the MOH and the ADB, additional survey scope may be included.  

XIX. Preliminary Survey Work Plan*

№

Activities

Executor

Work Schedule, in months

Baseline surveys

Project completion surveys

1

2

3

4

5

6

1

2

3

4

5

6

1

Finalizing of sampling methodology and developing data collection tools

1.1

Development of the sampling methodology and calculate the required sample sizes for PC, makhallas, respon to be included in the survey

Firm

Х

Y

1.2

Development of data collection tools (questionnaires, other data collection forms, data collection manual)

Х

Y

1.3

Development of data processing and data analysis plans

Х

Y

1.4

Translation of the tools to the agreed languages

Х

Y

2

Pre-testing and finalization of the data collection instruments

2.1

Form the group of interviewers to collect data

Firm

Х

2.2

Develop of data collector’s manual and conduct a training on data collection

Х

2.3

Preparation a detailed schedule for the data collection

Х

2.4

Testing the data collection instruments in Tashkent region

Х

2.5

Revision of data collection instruments based on test results

Х

2.6

Review of the sampling methodology and data collection tools by the MOH Working group

Project/MOH

Х

2.7

Revision of the sampling methodology and data collection tools based on the comments of the MoH working group

Firm

Х

2.9

Selection and compilation of list of surveyed PC and makhallas

Х

2.10

Submission of the report on the preparatory work

Х

3

Data collection and entry

3.1

Selection and compilation of list of surveyed households and PC

Firm

Х

Y

3.2

Field data collection and data checks

Х

Х

Y

Y

3.3

Submission of the results of the data collection

Х

Y

4

Statistical data processing

4.1

Data cleaning

Firm

Х

Y

4.2

Statistical data processing

X

Y

5

Data analysis

5.1

Data analysis

Firm

X

Y

5.2

Development of statistical tables

X

Y

5.3

Submission of the results of the data processing and statistical analysis

X

Y

6

Report preparation

6.1

Preparation and submission of draft analytical report

Firm

X

X

Y

Y

6.2

Discussion of draft analytical report with the MoH working group

Project/MOH

X

Y

6.3

Revise the analytical report based on the comments of MoH working group

Firm

X

Y

6.4

Obtain agreement on the analytical report from the MOH Working group

Project/MOH

X

Y

6.5

Translation of final report into English language

Firm

X

Y

6.6

Submission of final report and other survey documents and databases

X

Y

 

 

* Note:

The work plan can be changed during negotiations with the Company.

X = BASELINE SYRVEY

Y = project completion survey