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Project Overview and Role:
The purpose of the Uganda Health Systems Strengthening (UHSS) Activity is to strengthen the health system by improving leadership and accountability for achieving results across at all levels of the health system and across public and private sector. The activity seeks to strengthen MoH, RRH and and district-level leadership and governance systems; support domestic resource mobilization initiatives; support interventions that improve efficient use of available health resources; and strengthen community system for improved quality health services.
Primary Duties and Responsibilities:
The Uganda Ministry of Health (MoH) launched its Quality Assurance Program in 1994, which later transitioned to the Quality Assurance Department (QAD) under the Directorate of Planning and Development. In 2017, this later became Standards, Compliance, Accreditation & Patient Protection (SCAPP) Department. The mandate of the SCAPP Department is to ensure that the quality of services provided is within acceptable standards for the entire sector, both public and private health services. This is operationalized within the decentralized system using the District Health Office as the focal point under decentralization, under the coordination of the Regional Referral Hospitals (RRHs) support supervision mechanism.
The 2015/2016 – 2019/2020 National Health Quality Improvement Framework (QIF) and Strategic Plan (SP) seeks to enhance access to improved health care services in Uganda and improve consumer acceptability and satisfaction.” To ensure improved health outcomes, the MoH developed Service Delivery Standards in the country, are based on the Basic Care Package of Uganda (1997), Uganda National Minimum Health Care Package (UNMHCP, 2000), the report of the Minimum Service in Uganda’s Health Sector Standards (2009), the sector clinical and non-clinical guidelines and program specific standards including the MoH quality of care standards.
Although the MoH has developed some standards, these are scattered across different projects and programs and not well institutionalized. In addition, there changing health needs and growing need to improve the quality of services. The Government of Uganda is currently developing the National Development Plan (NDP) III and Health Sector Development Plan (HSDP) II strategies which call for improving the quality of care at all levels of health service delivery. In addition, the 2016 WHO framework on integrated, people-centred health services, the trend is moving in the direction of patient-centred care and measures of quality focused on processes of care.
Development, refinement and integration of quality standards of care has been identified as priorities, because to-date, there has been little and fragmented guidance available, except for evidence-based clinical practice guidelines. MoH needs to update the 2016 Service Standards into a comprehensive service standards manual and ensure alignment with the the new WHO service standards guidelines especially with HIV/AIDS and RMNCAH services.
It is against this background that the USAID Uganda Health Systems Strengthening (UHSS) Activity, in collaboration with the Ministry of Health, is seeking to hire the services of a consultant to support the development of the comprehensive Health Sector Services Standards manual.
Scope: The health sector services standards manual developed should address the following areas.
- The health sector services standards developed should describe priority areas for quality improvement in priority areas of health care or service, and include both ‘quality statements’ that are aspirational but achievable as well as ‘quality measures’ that will be used to assess the quality of care or service provision specified in the statement.
- The health sector services standards developed should enable practitioners to make decisions based on the latest evidence and best practices; allow payers (insurance firms, employers etc) to be confident that they are purchasing high quality and cost-effective services; enable services providers and users to know what quality of service they should expect to provide or receive; and allow benchmarking against other services.
- The health sector services standards manual will draw from the existing clinical guidelines and not substitute them. The clinical guidelines shall remain as recommendations on how health care professionals should care for people with specific health conditions and will include recommendations about providing information and advice as well as prevention, diagnosis, treatment, and longer-term management. However, the quality standards manual shall incorporate and integrate existing quality standards that are currently fragmented in different programs.
- The updated Health Sector Services Standards manual should addresses the scope of the quality challenges in the whole national health system levels: (i) At macro-level (e.g. financing, policy, planning, HRH and organizational structures that shape a health system, (ii) Meso-level (sub- national) level standards to address quality of health services through the coordination and management of a network of departments (for hospitals), facilities and communities and (iii) Micro-level standards that directly influence the performance of the staff or the operations of a facility or community care. Although informal providers (those with little or no formal clinical training) also provide care especially in the rural areas, there is insufficient data on the quality of care offered by these providers and will not be covered in these standards. In addition to care provided in facilities, the standards should promote the critical role of communities and service users in identifying their needs and preferences and in managing their own health.
- The Health Sector Services Standards manual should guide health care providers, managers and policy-makers in improving the quality of health services and based on the WHO health systems approach to identify areas that should be targeted to assess, improve and monitor quality care in the context of the overall national health system.
- The focus of the service standards is on the formal health sector, public and private service providers, including community health workers. The manual should include, but not limited to: service standards by level; then by the domains of the six-health system building blocks.
The purpose of the consultancy is to develop national health care and service quality standards across the national health system. The standards will enable health service providers and managers to improve in the delivery of quality health services in the country.
The specific objectives are:
- To review and harmonize the current MoH service standards with the current WHO service standards.
- To determine and provide clear descriptions of high priority areas for quality improvement in the country.
- To develop a Health Sector Service Standards manual.
- To establish service standard targets to be achieved and the service delivery indicators.
- Provide the operationalization strategy for the service standards.
Key tasks of the assignment:
- Document review and landscape analysis for quality standards in the health system.
- Preparing an inception report, key guidance sources, protocols, and tools for stakeholder inputs.
- Engagement and obtaining stakeholders (relevant MoH departments and programs, private sector and CSOs representatives) inputs into identifying priority areas, quality statements, targets, and measures.
- Develop draft quality standards and submit to the relevant technical working group (TWG).
- Conduct open consultation with wider stakeholders on draft quality standards and measurement
- Incorporate consultation comments, insights, and necessary changes into the document.
- Facilitate TWG workshop to draft quality standards, objectives, standard targets, as well as developing quality statements and measures
- Validation and checking: field testing, internal quality checking of both process and content.
- The quality standards are reviewed by health sector governance structures for approval.
- Completion, editing and preparation for publication.
The consultant will be expected to produce the following deliverables, approved by MoH:
- Inception report
- Draft Health Sector Services Standards manual
- A report on national, regional and district consultations
- Final quality standards manual approved by MoH
Key deliverables and Timelines and payment schedules:
The assignment shall be conducted over a period of 90 days beginning 18th August , 2020.
|Deliverables||Due date||Payable Amount (%)|
|1||Inception Report||31 August 2020||20%|
|2||Draft standards manual||30 September 2020||20%|
|3||Report on national, regional and district consultations||30 October 2020||20%|
|4||Final quality standards manual approved by MoH||10 November 2020||40%|
- Must hold qualifications in Clinical Medicine, Healthcare delivery or Community Health. Post graduate qualifications in Public Health, or Health Services management is preferred.
- Extensive expertise, knowledge, and experience with planning, standards development, and quality improvement/assurance in the health sector
- Knowledge of the Uganda Health System and process of development of Guidelines, Strategies and Policies for the Health Sector.
- Technical knowledge of governance, leadership, and the management of the health sector in Uganda, especially working with TWGs.
- Knowledge of the key stakeholders relevant for this activity and ability to convene meetings for purposes of obtaining comments and feedback from all the key stakeholders.
- Excellent writing and communication skills, formatting and editing skills and ability to quickly address technical and editorial comments made by stakeholders.
The consultant shall report directly to the UHSS Chief of Party with support from the UHSS Governance, Leadership and Accountability team lead and seek guidance. At the Ministry, the consultant will work closely with the Directorate of Governance & Regulation. Weekly and monthly check-in meetings will be held to keep track of the progress.
All interested parties are required to submit their expressions of interest highlighting their experience in conducting policy development and reviews, workplans, qualifications, names and contacts of three referees and a written quotation for completing the deliverables.
Payment for consultancy:
All payments for this consultancy will be made in local Ugandan Shillings (UGX). All payments will be subject to withholding tax as per Republic of Uganda’s taxation policies. For the payment schedule, please refer to the Table above.