DIABETES IN EAST AFRICA (DEAR) PROJECT, 2009-2012
Terms of Reference
Survey on Knowledge, Attitudes and Practices related to Diabetes
in Burundi, Kenya and Tanzania
Call for a Main Consultant
April 2010
BACKGROUND
a) Overview of Handicap International
Handicap International (HI) is an international non-governmental, non-religious, non-political and non-profit making organisation. HI works alongside people with disabilities, whatever the context, offering them assistance and supporting them in their efforts to become self-reliant.
Since its creation in 1982, the organisation has set up programmes in approximately 60 countries and intervened in many emergency situations. It has a network of eight national associations (Belgium, Canada, France, Germany, Luxembourg, Switzerland, United Kingdom, and USA) which provide human and financial resources, manage projects and raise awareness of Handicap International’s actions and campaigns.
b) Overview of the Diabetes East Africa Region (DEAR) Project
On December 2006, the United Nations General Assembly passed a landmark Resolution recognizing diabetes as a chronic, disabling and costly disease associated with major complications that pose severe risks for families, countries and the entire world.
Building on the experience of Tanzanian Diabetes Association, Kenya Diabetes Association and CELUCODIA (Centre for the Fight Against Diabetes) in Burundi as well as the relationship developed with time at country level, Handicap International launched the, “Diabetes East Africa Region (DEAR) Project,” in 2008 with the goal to improve the quality of life of the people with diabetes and to reduce the incidence of disabling complications of diabetes within East Africa Region.
Towards this achievement, the project expects the following results:
- Local health systems have the capacity to provide quality diabetes care and rehabilitation services to the population in pilot zones
- Local capacities to empower the general population to prevent the onset of diabetes through changes in lifestyle are promoted and reinforced
- People with diabetes are empowered to access quality diabetes care, advocate for their rights, sustain their lives and decrease social and economic impact of diabetes
- Local and regional expertise networks are developed among stakeholders on diabetes in East Africa
The project aims to jumpstart community-level action in response to the emerging threat of diabetes in rural communities where Handicap International has longstanding relationships with health ministries and local stakeholders. In addition, with links to the international community, including the International Diabetes Federation, the project will support efforts to create awareness at the global level of the needs and local responses by those most impacted by the disease. Using knowledge gained by various groups in the region, the project aims first at reinforcing the health system response at the primary health care and secondary and tertiary care levels. Linking health services with community outlets will enhance their accessibility and affordability for the rural population. Stakeholders will look at solutions to key operational barriers in provision of affordable drugs. Awareness campaigns and local, national and international mechanisms of knowledge sharing will inform general population on the disease, its related risks and possible measures of prevention. The project promotes local ownership and seeks to demonstrate how integrated diabetes management (prevention, care, rehabilitation) needs to become a priority at every level. Establishing networks will facilitate coordinated solutions at local level. Support to advocacy will contribute to recognition rights of people with diabetes in local and national policies. Establishing and facilitating exchange of experience based on best practice will contribute to maximize and avail expertise within the 3 target countries and beyond.
Partners
Funding partners: This project is jointly funded by the European Union, Sanofi Aventis and Handicap International.
Implementing partners: This project is being implemented in 3 countries by the following HI partners:
- In Burundi, CELUCODIA (“Centre de Lutte contre le Diabète”) is the first and the only centre specifically dedicated to diabetes care in Burundi.
- In Kenya, Founded in 1997, the Kenya Diabetes Association-Kitale Branch (KDA-Kitale Branch) has a total of 240 members.
- In Tanzania, the Tanzania Diabetes Association (TDA) is a new implementing partner with Handicap International. The TDA is a very strong stakeholder that has been working with the Ministry of Health in the implementation of a network of outpatient diabetes care units (“diabetes clinics”) in district and regional hospitals.
The above implementing partners are working in very close collaboration with the relevant ministries, including the ministries responsible for health and medical services, education, youth, social services, among others.
Target groups
The key persons from institutions and communities who will be engaged in the response to diabetes in Burundi, Kenya and Tanzania:
- 70 health workers;
- 60 active members of diabetes associations;
- 60 community resources persons.
The people who will benefit directly from the project activities during the 4 years include:
- At least 46,200 people with diabetes, 9,240 being new cases.
- At least 180,000 people will be reached by awareness raising activities. This means that each country will reach 60,000 people
Evaluation of the DEAR project
An assessment of the DEAR project is planned in each country (Kenya, Tanzania, and Burundi) to evaluate the evolution of quality of care provided by diabetic clinics targeted by the project and the evolution of the awareness of diabetes and its complications in target zones.
This assessment will be carried out in two phases, at the beginning of the project (2010) and at the end (2012).
A baseline assessment is planned in 2010 and consists of three surveys:
- A clinical audit
- A patient satisfaction survey
- A knowledge, attitude and practice survey (KAP survey)
KAP SURVEY OBJECTIVE
The objective of the KAP survey is to assess the knowledge, attitudes and practices of the general population from the three pilot zones, including men and women with diabetes in order to determine and inform the form and content of the message to be delivered, as well as to provide baseline indicators for montoring and evaluation purposes.
KAP SURVEY METHODS
Study zones
The study zones are the pilot areas for the DEAR project:
- Tanzania: Arusha, Meru and Monduli districts
- Kenya: Kwanza, Trans-Nzoia West and East districts
- Burundi: Bujumbura and Ngozi districts.
Survey typology
The KAP surveys will be cross-sectional and will be carried out at in 2010.
Data collection method
Survey instruments will be developed by the Main Consultant retained, and validated by the Deputy Technical Advisor together with the M&E Officer for the DEAR Project.
SCOPE OF WORK
The Main Consultant is expected to:
- Understand the DEAR project objectives and strategies
- Conduct a literature review and in particular the main consultant must acquaint him/herself with the study carried out in the DEAR countries (in particular, KAP and STEP-wise approach surveys)
- Develop a pre-survey report, including the literature review, methodology of the study, the sampling procedures, the data collection methods, tools, planned analysis… as well implementation of the baseline survey including the timeframe and budget.
- Design, develop, pre-test and refine data collection tools to generate the needed baseline information in each context
- Brief and train the national consultants about quantitative part of the KAP survey
- Train the surveyors/interviewers in collaboration of national consultants
- Supervise the surveys in the three countries
- Produce a consolidated KAP survey report with results presented by country.
KEY DELIVERABLES
a) Before Main Consultant is selected
- Baseline survey proposal
b) Once Main Consultant is selected
- A pre-survey report as specified under, “scope of work.”
c) After implementation of the baseline survey
- A soft and hard copy of the baseline survey report (in English language) outlining key findings in the data implications as well as recommendations.
- An oral presentation of the findings to the stakeholders in each country at local and national levels.
- All study materials including soft copies of all data sets both quantitative and qualitative and data recording materials
CONTRACT DURATION AND TIMEFRAME
The Main Consultant should develop a detailed and feasible costed-workplan/activity schedule that should be congruent with the timelines provided below. The costed workplan should be submitted as integral part of the proposal for consultancy. The successful consultant must commit to accomplish and deliver the consultancy services and deliverables before the dates indicated in the table below.
Table: Proposed timelines for KAP baseline survey
| Activity | Burundi | Kenya | Tanzania | ||
| Reception of proposal and recruitment of Main Consultant (signing the contract) | 3rd -30th May | ||||
| Pre-survey report writing, surveys tools creation, submission, review, and agreement | 3rd -30th June | ||||
| Surveyors Training, pre-testing survey, tools reviewing | 15th-26th August | 1st -15th July 2010 | 16th -31st July | ||
| Coordination/supervision of the field survey | 1st September -15th October 2010 | 15th July – 30th August 2010 | 1st August– 15th September 2010 | ||
| Data-entry | 15th September – 30thOctober 2010 | 1st August-15th Sept 2010 | 15th August-30th Sept 2010 | ||
| Submission of first draft of baseline report | 1st December 2010 | 15th October | 30th October | ||
| Review and feedback of the baseline report by survey committee | 15th December 2010 | 30th October 2010 | 15th November 2010 | ||
| Oral presentation of the survey findings results and validation of the report by the stakeholders | November December 2010 | November 2010 | November 2010 | ||
| Submission of final version of the baseline survey reports | 31 december 2010 | ||||
EVALUATION AND AWARD OF CONTRACT
Handicap International will evaluate the proposals based on the technical and financial feasibility. However, technical feasibility shall serve as the main guideline for screening the proposals. The Main Consultant should meet the following minimum requirements:
- Academic background in Medical or Social Sciences with a minimum of Masters Degree qualification
- Knowledge about diabetes management is an added advantage
- Experience in conducting KAP surveys or STEP-wise approach survey is an added advantage.
- Experience in using a range of qualitative and quantitative data collection and analysis methods
- Strong analytical and report writing skills
- Proficiency in use of computers, especially MS Office packages and a MUST in the use of statistical software as SPSS.
N/B. Handicap International reserves the right to accept or reject any proposal without giving reasons and is not bound to accept the lowest or the highest bidder.
CONTRACTUAL RESPONSIBILITIES
The Main Consultant will be responsible to the DEAR M&E Officer. He/she will be in charge of national consultants who will be recruited from the countries under study.
The Main Consultant will be responsible for the following:
- Prepare and deliver the consultancy services as per this TOR.
- Obtain maximum input from major project stakeholders.
- Design, review and refine the data collection tools
- Design data input templates, supervise data entry, data cleaning and data quality
- Write a baseline pre-survey report.
- Produce a consolidated KAP survey report with results presented by country
PAYMENT MODALITY
The payment for the work shall be as follows: 40% down payment upon signing of the contract, 40% upon submission of an acceptable second draft report, 20% upon presentation of a satisfactory final baseline report.
EXPRESSION OF INTEREST
A Consulting firm that meets these requirements and is available within the time period indicated should submit the following:
- A brief summary of the firm and at least 1 Main Consultant who will undertake this assignment, including a commitment to be available to undertake the entire assignment within the stated timelines.
- An elaborate methodology and detailed costed work plan indicating number of days and tasks and costs per main task (include number of consultant days) - this should not exceed 5 pages.
- Curriculum vitae of the Main Consultant proposed for the assignment. Their relevant qualifications, skills and experience as well as full contact details of two referees.
