ThaiNGO

Terms of Reference:

Activity to strengthen the Community Based Monitoring

02 August 2021

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 15^th.

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:

1. 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.

2. 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 Component B - CBM data use consultant:

• In Sri Lanka, Mongolia, Lao PDR, Bhutan, and Timor-Leste, work with SKPA Country Leads and in-country teams to plan and document processes, methods and findings around implementation of CBM conducted to date – starting with the analysis of CBM/S&D data and how it is used - to support country partners to produce more relevant and appropriate analyses and guidance to facility/services managers and national program managers focusing on access to, quality and KP friendliness of health services with a view to informing guidance around recommended practices in the CBM toolkit, including:

• The constituents of CBM groups in each country

• The mechanism to report identified issues to stakeholders

• Practices around the collection, aggregation, analysis of CBM data at local and national level, including a sample analysis/feedback template, sample agenda for a feedback meeting, and list of participants

• Different complaints mechanisms for S&D in each country, what are the mechanisms, and functional roles of various stakeholders (Lao PDR and Timor-Leste only)

• How patients/KPs are made aware of complaints mechanisms, and what steps they need to follow to use them (Lao PDR and Timor-Leste only)

• What share of complaints are being reviewed within 30 days, what kinds of complaints are they, what proportion are responded to, and what are the examples of responses

• Different CBM feedback mechanisms in place at different levels, from local to national – including who are the different stakeholders involved, what forums in which data are being reviewed and discussed, how feedback is taking place, as well as what constitutes a best practice in feedback

• How are data being used to inform KP service improvement in each country, which forums are best for planning and action, who are the key stakeholders that are involved, and real examples of how the review of data is leading to improvements in KP-friendly services

• The roles of KPs in the steps above, and recommendations for KP engagement

• Submit the revised CBM and S&D data analyses and response resommendations To SRs and PR as documentation for achievement of WPTM #3 and WPTM #7 milestone achievement for SKPA. Where these activities have not taken place, work with SRs and CLs to design country-specific implementation plans for remedial action in SKPA to support achievement of milestones under WPTM #3 and #7.

NB. Timor-Leste is excluded from the tasks above, except where noted.

• Collate lessons learned from the SKPA countries (drawing on best practices reviewed, including those from other settings), and draft the use of CBM data for improving KP-friendly HIV services sections of the CBM toolkit, including):

  1. strategies and processes for data analysis

  2. good practices and strategies for establishing feedback of results and packaging the information for decision makers  (program managers, health facility managers and participating communities)

  3. steps for establishing response and remediation interventions for complaints reporting

  4. using information generated for advocacy, demand generation and service improvement to target communities

Deliverables: Component B - CBM Data Use Consultant

Timeline for Phasing of Consultant Inputs

Selection Criteria – Component B: CBM Data Use Consultant

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