Overview

Job Description

Global Fund TB program Radiology services-World Vision

Closing date: 14 Feb 2021

TOR- Global FundTB program Radiology services-World Vision Somalia (Remote Interpretation of X ray images for diagnosis of TB for the Somalia National TB program through the Min X-ray cloud system)

Global Fund – TB program Radiology services (Remote Interpretation of X ray images for diagnosis of TB for the Somalia National TB program through the Min X-ray cloud system)

Terms of Reference (ToR)

1. Activity Summary

Project Name: Somalia Global fund Tuberculosis (TB) program

Activity Type: TB program Radiology services

Purpose of the consultancy: Improve TB diagnostic system. Improve Increase access to quality Tuberculosis diagnosis services.

Proposed Methodologies: Remote Interpretation of X-ray images for diagnosis of TB for the Somalia National TB program through the Min X-ray cloud system

Proposed Monitoring Dates:1st January, 2021 – 31st December, 2023

Reporting Dates:Monthly (Every 1st of the following month after end of month)

2. Description of Program

Project Goal: Reduce the incidence of TB (all forms) by 50% by 2025 and 90% by 2035 (from 2015 baseline figure)

Project Objectives

  1. Increase TB treatment coverage (case detection ratio) to 50% by 2020 (from baseline of 47% in 2015)
  2. Increase treatment success to at least 90% in all forms of detected non- Multi-Drug Resistant (MDR) TB cases
  3. Increase annual case detection of MDR- TB to 400 by 2020 (from baseline of 243 in 2016) and improve management of MDR-TB cases through country-wide implementation of the shorter MDR-TB treatment regimen
  4. Ensure that 100% of new staff receive induction training and that 50% of TB service facilities receive regular supervision and monitoring by 2022

Project Outcomes

  1. TB O-1a: Case notification rate of all forms of TB per 100,000 population – bacteriologically confirmed plus clinically diagnosed, new and relapse cases
  2. TB O-5(M): TB treatment coverage: Percentage of new and relapse cases that were notified and treated among the estimated number of incident TB cases in the same year (all form of TB – bacteriologically confirmed plus clinically diagnosed)
  3. TB O-5(M): TB treatment coverage: Percentage of new and relapse cases that were notified and treated among the estimated number of incident TB cases in the same year (all form of TB – bacteriologically confirmed plus clinically diagnosed)
  4. TB O-6: Notification of RR-TB and/or MDR-TB cases – Percentage of notified cases of bacteriologically confirmed, drug resistant RR-TB and/or MDR-TB as a proportion of all estimated RR-TB and/or MDR-TB cases
  5. TB O-4(M): Treatment success rate of RR TB and/or MDR-TB: Percentage of cases with RR and/or MDR-TB successfully treated

Project location (Districtsand # of villages/ sub-Puntland locations) , Somaliland and Federal Government of Somalia

Number of target beneficiaries-16, 109,000 which is the total population of Somalia (Worldometer)TB patients

Sectors-Health

Key Project Activities

  1. Drug sensitive TB diagnosis
  2. Drug sensitive TB treatment
  3. Drug resistant TB diagnosis
  4. Drug resistant TB treatment
  5. TB/HIV collaborative activities( ACSM, PPM)
  6. Procurement and supplies distribution

Donor: Global Fund to fight TB, AIDS and Malaria

Duration of the Program:3 years

Available Project Documentation

Somalia TB strategic plan, performance framework, project log frame, Inventory study report, Patients’ perspective toward TB treatment report (Quote Study), Impact Evaluation report, KAP Surveys, PU/DRs

3. Brief Background of Project

Globally, 6.3 million new cases of TB were reported in 2016, equivalent to 61% of the estimated incidence of 10.4 million. According to WHO World TB report 2016, Somalia has one of the highest TB incidences rates in the world estimated at 270/100,000 with a prevalence rate of 481/100,000 and estimated mortality (excluding HIV/TB) rate of 64 per 100,000 population. According to the latest UNFPA report, Somali population is estimated to be 12.3 million. TB continues to contribute to the disease burden in Somali, with the latest WHO TB report estimating a Case Detection Rate (CDR) of only 49%, meaning 51% for all the cases (estimated) are being missed or undetected and majority of these are believed to be at the community level. In the last 5 years, case notifications have shown continued fluctuation and decline.

In Somali, TB control service provision is managed under the National Tuberculosis Programme (NTP) within the Ministry of Health (MOH). However, after the collapse of the central government in Somalia in 1990, TB control service provision have been implemented through key partners who consist primarily of international and national Non- Governmental Organizations (NGOs) with WHO providing the technical expertise in collaboration with Somalia government. From 2004, TB control have been funded chiefly by the Global Fund for AIDS, Malaria and TB (GFATM). World Vision (WV) is the principle recipient. Further, the government contributes to the implementation through provision of infrastructure, security support and facilitation of the NGOs involved in the TB control.

Despite being at its infancy stage and the complex political and security in the country, the Somali government has made progress in TB control and management. Access to TB services has generally improved through an increase in the Out-Patient Department (OPD) services and laboratory network for microscopy services implemented according to the Stop TB Partnership global DOTS strategy. With uninterrupted funding from the Global Fund since 1995, access to TB services and treatment have increased from 12 TBMUs in 1995 to 83 by December 2016. Quality diagnosis and treatment resulted in a treatment success rate of above the 85% global threshold. In 2015, the government finalized the development of the second National TB 2015-2019 strategic plan. This was followed by the completion of the monitoring & evaluation (M&E) plan that will guide the implementation of the strategic plan. The Strategic Plan contributes to the Somali Health Policy goal of improving the health status of the population through health system strengthening interventions and providing quality, accessible, acceptable and affordable health services that facilitate moving towards Universal Health Coverage (UHC) and accelerate progress towards achieving the health-related Sustainable Development Goals (SDGs).

Without diminishing the TB control and management progress made in Somali, TB program have not expanded as desired. There has been a slow progress in improving the existing infrastructure to increase their capacity as well as establishing new health facilities to meet the community needs or ensuring quality of the services. Required additional resources in terms of workforce, infrastructures, equipment and supplies have been limited. At present, the Global –Fund supported TB program in Somali is implemented by World Vision International Somalia Program (WVI-S) working in with other Somalia TB program implementing partners. The Somalia Health Sector Committee (HSC) and the TB Coordination Team (TBCT) provides the Country Coordination Mechanism (CCM) for the program.

4. Purpose and Objectives of the engagement

Diagnosis is one of the most important process in management of TB. Chest X rays play important part in the diagnosis of TB where other diagnostic tests are not possible and also in pediatric suspected patients.

TB treatment facilities in Somalia do not have a resident radiologist for the interpretation of Chest X-ray images for diagnosis. The solution for this is remote interpretation of the X-ray images by a radiologist.

The World Vision Somalia TB program has 27 X-ray equipment (Minx-ray) for diagnosis of TB. This equipment has ability to automatically upload images into a cloud system for interpretation. The images can then be remotely interpreted and diagnosis made and reported to the clinicians

Objectives:

o Remote Interpretation of (Chest) X-ray images through the Min X-ray cloud system to aid in increasing access and prompt diagnosis of TB and thereby improving diagnostic capacity of the Somalia National TB program

5. Scope of the Engagement

o All Somaliland TBMU with Min X-ray system

o All Puntland TBMU with the Min X-ray system

o All Federal Government of Somalia TBMUs

6. Logistics

Based on this ToR, the successful entity will propose a suitable approach and cost of interpretation per image. Upon approval of the technical approach a meeting will be arranged with the project team to agree on the frame of operation and responsibilities of each party.

WV Somalia GFTB PR team together with Quality Assurance team will support the successful entity in understanding its program model and the standard tools used in monitoring related activities. WV Somalia will also ensure that necessary linkages are created between the laboratory consultant, field staff and implementing partners.

7. Responsibilities of Consultant

o Remote Interpretation of (Chest) X-ray images through the Min X-ray cloud system uploaded by clinician in TBMUs in Somalia

o Reporting of the Interpretation through the Min X-ray cloud system with 48 hours of the images being uploaded

8. WV Responsibilities during evaluation

o Provide necessary orientation and training to the selected entity

o Provide the selected consultant with necessary documents to enable clear understanding of the project

o Create linkages with field staff, Implementing Partners/SRs and other stakeholders

o Review reports and data sets to ensure quality. Equally provide on-going feedback to the consultant

· Deliverables

o Monthly reports detailing number of uploaded images interpreted and reported in the Min X-ray cloud system

9. Proposal Contents

Proposals from Individuals consultant should include the following information (at a minimum) **

  1. Proposed cost of per image interpreted and reported in the Min X-ray cloud system
  2. CVs of key team members for this engagement.

10.Qualifications of the Consultant

Education:

o MBCHB from a recognized university

o M med Radiology from a recognized university

Experience and competence:

  1. Experience in the interpretation of Chest X-ray images for diagnosis of TB
  2. Experience in the use of remote X-ray diagnosis programs or software

11.Evaluation Criteria

  1. Education qualifications

o MBCHB from a recognized university

o M med Radiology from a recognized university

  1. Experience in the interpretation of Chest X-ray images for diagnosis of TB
  2. Experience working with National TB Program or other TB programs
  3. Experience in the use of remote X-ray diagnosis programs or software
How to applyApplication Process

All interested bidders are requested to submit their technical proposal together with CV’S and Financial Proposals in Separate documents as attachments (Bidders who will combine both technical and financial proposals shall be disqualified) via email somo_supplychain@wvi.org on or before 14th February 2021.

Bids received after deadline shall not be considered.

Email title should be; – Global Fund TB program Radiology services

Your financial proposal should have proposed cost of per image interpreted and reported in the Min X-ray cloud system and any other related cost well tabulated. Financial proposal should not be part of the technical proposal, it should be a separate document.