Terms of Reference:
Activity to strengthen the Community Based Monitoring
02 August 2021
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Title |
TOR to develop a Comprehensive Toolkit for Community Based Monitoring |
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Duration |
Component A: 50 days – Toolkit Specialist |
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Location |
Remote |
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GF Grant #, if applicable |
QMZ-H-AFAO |
Background
The Australian Federation of AIDS Organisations (AFAO) is the national federation for the community response to HIV in Australia. It provides leadership, coordination and support to the country’s policy, advocacy and health promotion on HIV. AFAO’s International Program is based in Bangkok and contributes to the development of effective policy and programmatic responses, particularly in the Asia and Pacific region. It has supported community-based responses to HIV across the region for three decades.
AFAO is the Principal Recipient of the Sustainability of HIV Services for Key Populations in Asia Program (SKPA Program). The program is a multi-country grant funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) covering eight (8) countries: Papua New Guinea (PNG), Timor-Leste, Malaysia, Philippines, Laos, Mongolia, Bhutan and Sri Lanka. It aims to promote sustainable services for key populations (KPs) at higher risk of HIV exposure including sex workers, men who have sex with men, transgender people and people who use drugs, in the region. The Sustainability of HIV Services for Key Populations in Asia (SKPA) Program is currently in its last year and a new request for applications for the follow on 3 year South East Asian multi-country grant, has been released, with a due date of August 15th.
Objectives
The purpose of these consultancies is to address attrition in the HIV treatment cascade by enhancing KP monitoring and feedback on the availability, quality and friendliness of HIV services. This requires periodic or regular collection of information from clients of health services including for HIV testing, and for those who test positive, HIV treatment and treatment monitoring. Irrespective of the key population group, everyone has the right to expect certain standards of services, and this toolkit will mobilise Regional KP Networks s and KP groups at country level around supporting their constituents to participate in monitoring that those standards are met and maintained. This toolkit will establish a core set of indicators on service availability, quality and friendliness for HIV services. Additional adaptations and customisation can be applied to individual KP groups as needed.
Scope of the Consultancy
This Scope of Work for the consultancy is divided into two components, which reflect the two significant tasks in revising and implementing a successful KP-led CBM multi-country initiative. These tasks are complementary and due to limited time remaining in SKPA (which ends on 31 Dec 2021) will run concurrently to produce the toolkit in time to allow for field testing and finalisation before the end of the year. The two components comprise:
CBM Methodology lead consultant (Toolkit specialist): to work with AFAO and four regional KP networks based in Bangkok (APCOM, APN+, APNSW, APTN and Youth LEAD) and in collaboration with the Global Fund and UNAIDS to develop a comprehensive modular toolkit to guide implementation of Community Based Monitoring (CBM) that promotes KP feedback on both service access and acceptability issues, including S&D.
CBM Data Use Consultant: to work with AFAO, the methodology lead consultant, and in-country teams in four countries (Mongolia, Bhutan, Lao PDR, Sri Lanka) to review data collected during past CBM exercises and two countries (Lao PDR and Timor-Leste) to review data collected in S&D feedback mechanisms, and how this data was subsequently collated, summarised and used, to support country partners to produce more relevant and appropriate analyses and guidance focusing on access to, quality and KP friendliness of health services. The consultant will assess mechanisms for KPs to make complaints or provide other feedback on HIV services, and document these as well as practical steps to improve services following the feedback, across the four countries through data use case studies and preparing guidance for inclusion in the CBM toolkit. Documentation generated as part of these combined efforts will also facilitate SRs and AFAO’s assessment of progress to meet milestones under SKPA work plan tracking measure (WPTM) 3 and WPTM7, as well as contribute to developing the data use section of the CBM toolkit.
This two-pronged consultancy is to be conducted concurrently and and in coordination with a separate consultancy being undertaken with APCOM to revise their current “Guide to Implementing Community Based Monitoring” which is reviewing experiences and tools used to date for CBM conducted in several countries. That consultancy will develop the CBM tools for MSM which will be incorporated as a component of the product of the Methodology consultancy. In addition to the MSM module, the toolkit will have modules with content appropriate to conducting CBM among other priority populations. In all, the modules should comprise (pending consultation with regional networks): MSM, Transgender Persons, People Who Use Drugs, Sex Workers and PLHIV.
Tasks under Compoent A - Toolkit Specialist:
There are 6 main tasks for the SoW, with additional details in the deliverables section:
Review APCOM consultant’s synthesis report of CBM Protocols and Tools, and feedback from SKPA countries implementing CBM; review Trans COMP CBM toolkit from APTN; review S&D data collection tools with APN+ and their Concept paper on “Client Feedback Mechanism for PLHIV and Key Populations”.
Present the common features shared between tools, important methodological and content gaps that limit the utility of current tools being used in SKPA countries, and recommendations for a new core framework and methodology for integrated CBM/ S&D routine data collection for all KP target populations and present to Regional Network partners, AFAO, Global Fund and UNAIDS for agreement on the core methodology.
Work with Regional Network partners to customise the toolkit for their relevant constituents, including developing specific modules that may include additional variables/indicators, service considerations and case studies needed for each target population.
Draft the CBM Toolkit with components including but not limited to:
Describe the overall objective and scope of conducting CBM by community groups in a sustainable manner
Prepare a list of indicators (approx. 10-20) with detailed definitions and disaggregations for each of the main KP groups (MSM, Transgender persons, People who use drugs, Sex Workers, young people affected by HIV and PLHIV), representing a ‘community pulse’ on key health and HIV services access and acceptability.
Design sample/core questionnaires/scorecards for each target population to go with the new lists of indicators (drawing on APCOM MSM CBM Module for the MSM component of the overall CBM toolkit and including guidance from APN+ on core S&D questions to include in the scorecards) and guidance (steps/stages to refine or customise the templates according to particular country-specific or population-specific focus areas
Develop guidance for sample size determination (if any) and facility-based or community sampling process
Define the protocol or process for collecting and analysing the data including sections a-d above, as well as (but not limited to):
Participant recruitment and eligibility screening
Site preparation and site management during data collection
Ethics including informed consent, potential risks and benefits
Data collection strategies (self administered questionnaire vs interview, paper vs digital recording)
Data validation and verification
Analysis plan and analysis templates for each of the score cards
Develop concise vignettes or case studies (2-3 for each KP group) that communicate the types of barriers each KP group face when accessing HIV services.
Draft sample training/orientation workshop outline and agenda for individuals collecting data and minimum training, if applicable
Provide a selection of materials to be used in training, and list of others that need development
In collaboration with the data use consultant, prepare guidance on strategies for use and packaging of results (standard formats, templates or infographics highlighting the core indicators mentioned above) of CBM for national program managers, health facility managers and staff, as well as communities who are clients of the services being monitored
Provide guidance for community organisations and health service managers to use results of CBM to address issues that emerge, express how solutions have been aggreed in order to promote and generate demand for KP friendly services
Suggest processes to institutionalize CBM at the organizational level with recommendations on implementation frequency and selection of recurrent topics and cycling/consideration of other non-core topics to investigate in subsequent rounds
Disseminate draft CBM toolkit and incorporate any comments from AFAO APCOM/APN+/APTN teams, and comments from Global Fund and UNAIDS
Prepare a brief toolkit orientation/introductory overview for users who would like to apply it for conducting CBM activities (as a powerpoint or video
Submit revised CBM toolkit after incorporating comments.
Deliverables – Component A: Toolkit Specialist
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Activity |
Details |
Outputs |
Number of working days |
Timeline |
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Review will incorporate findings on the synthesis of CBM experiences by the APCOM MSM CBM Module consultant; APTN Trans COMP CBM toolkit review; APN+ S&D data collection tools review and their Concept paper on “Client Feedback Mechanism for PLHIV and Key Populations”
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6 |
By Aug 20, 2021 |
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1 |
By Aug 25, 2021 |
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Prepare specific modules that will include additional variables/indicators, service considerations and case studies needed for each target population |
Plan for modularisation and development of customisations for each target population |
5 |
By Sep 1, 2021 |
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Work with AFAO, APCOM, APTN, APN+ to draft CBM toolkit |
As above under Scope of Consultancy |
30 |
By Oct 1, 2021 |
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Disseminate work to date to AFAO, APCOM, APTN, APNSW and APN+ teams |
Present the new toolkit and solicit written feedback |
1 |
By Oct 6, 2021 |
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Develop an introductory guide to the toolkit, in video or ppt format |
CBM toolkit orientation/introduction ppt/video |
1 |
By Oct 10, 2021 |
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Incorporate recommendations from dissemination meetings into final draft for testing |
SKPA CBM toolkit with feedback from draft meeting incorporated |
6 |
By Oct 15, 2021 |
Timeline for Phasing of Consultant Inputs
Selection Criteria – Component A: Toolkit Specialist
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Essential
Desirable
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Supervisors
Mike Merrigan
Senior Technical Lead, AFAO/SKPA Program
Email: mike.merrigan@afao.org.au
Brad Otto
Senior Technical Advisor, AFAO/SKPA Program
Email: brad.otto@afao.org.au
Application please send to Nalatthaporn.Chayshoowong@afao.org.au
Contact : Nalatthaporn.Chayshoowong@afao.org.au
