ThaiNGO

Terms of Reference (TOR) for

a Consultant to conduct operational research on LLIEIN usage and associated factors in mobile and migrant populations, particularly forest-goers, to support malaria activities in Ubon Ratchathani and Si Sa Ket provinces of Thailand

Under the program title Regional Artemisinin-resistance Initiative to Elimination (“RAI2ZE 2018-2020”) Regional Component

Finance by The Global Fund to Fight AIDS, Tuberculosis and Malaria

Contents in the TOR

1. Purpose 8. Deliverables
2. Background 9. Payment and Consultant Fees
3. Objectives of the TOR 10. Rights and Properties
4. Expectation 11. Qualifications and Required Documents
5. Scope of Work 12. Key Contact
6. Duration 13. Appendix
7. Duty Station

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1.Purpose :

The purpose of these Terms of Reference (ToR) is to hire a professional consultan (Consultant) to design and conduct operational research for the RAI2E project. The main focus of this study is to follow up and assess LLIHN usage, but also clearly identify behaviors and needs of, and factors relating to, hard-to-reach MMPs, particularly forest-goers, to improve service delivery of Raks Thai Foundation,

according the scope of work in these TOR.

Raks Thai Foundation (Raks Thai) is responsible for the ToR under the Regional Artemisinin-resistance Initiative to Elimination (RAI2E), which is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) through the United Nations Office for Project Services (UNOPS).

2.BACKCROUNDE

The Regional Artemisinin-resistance Initiative to Elimination (RAI2E) is a multi-

country initiative funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) from 2018 to 2020. This initiative is implemented through strategic partnerships across the Greater Mekong Subregion (GMS), which includes Myanmar, Thailand, Laos, Cambodia and Vietnam. Through this initiative, the Greater Mekong Subregion has committed to eliminate malaria by 2030, and earlier in some countries.

Civil Society Organizations in the GMS work in partnership with the government; providing services in active foci areas (active transmission in the last 6 months) which include established villages and remote and hard-to-reach communities, which include national, mobile, migrant and ethnic populations.

Raks Thai Foundation has been engaged with the Global Fund since its inception, and currently implementing two projects under RAI2E; the Country Component and the Regional Component. The Country Component is implemented in Ubon Ratchathani, Si Sa Ket, Kanchanaburi, Ratchaburi, Prachuap Kiri Khan, Chumphon, Surat Thani, and Ranong. The Regional Component supplements programmatic gaps in Ubon Ratchathani and Si Sa Ket. In addition to Raks Thai Foundation’s work, civil society organizations (CSOs) also implemented malaria activities in Mae Hong Son, Tak, Songkhla, Yala, Pattani, and Narratiwat.

Activities are implemented according to three main strategies: 1. Building community resilience to contribute to malaria elimination 2. Responding to active transmission through the 1-3-7 Strategy 3. Distribution of long-lasting insecticide treated nets and hammock nets (LLIN/LLIHN)

Northeast Thailand, the focus of the Regional Component, is one of the highest malaria burden regions in Thailand. Between 2015 and 2016, the region saw a significant decline (400%) in malaria (4564 to 1134). However, in following years, the malaria incidence has slowly increase again by approximately 10-15% per year (1134 in 2016, 1249 in 2017, 1435 in 2018). The highest incidence is found along the borders with Cambodia and Lao PDR, and assumed to be related to limited and irregular service access and behaviors of the populations. In 2018, there were 1345 cases in the region (SS: 908, UB: 527). Of these, males accounted for 93% and 91% respectively, and Thai nationals accounted for 97% and 99% respectively.

Goal:

To make an as large as possible contribution to the elimination of falciparum malaria from the GMS, and to prevent the emergence or spread of artemisinin resistance.

Objectives: ¢ To interrupt transmission of P. falciparum through usage of long-lasting insecticide treated hammock nets by targeted populations. ¢ To provide access to prevention, diagnosis and treatment for mobile and migrant populations. ¢ To closely monitor trends in LLIHN usage and health seeking behavior, to identify and take action to control outbreaks.

During 2018, Raks Thai Foundation conducted various activities to support malaria

elimination from the region. This included detailed mapping of all active foci areas,

including communities and worksites, conducted health education sessions, organized

mobile testing, and distributed LLINs and LLIHNs to malaria affected communities

and individuals. These activities were conducted in 21 townships, comprising 71

villages, with a total population of 67,934 people. Within this area, we included

established villages within 5km of forest areas, ethnic monitory groups and large

settlements associated with plantations. In addition, we specifically prioritized mobile

and migrant populations (MMPs) working and living in the areas highlighted above,

estimated as 8% percent of the total population. These MMPs include:

-Seasonal agricultural laborers and plantation workers.

-Traditional slash-and-burn and paddy field farming communities visiting their forest farms

-Forest workers in the formal sector (police, border guards, forest/wildlife protection services)

-Forest workers in the informal sector (hunters, small-scale gem/gold miners, people gathering forest products [precious timber, construction timber, rattan/bamboo]

-Formal and informal cross-border migrant workers (Legal and illegal workforces)

These mobile and migrant populations (MMPs) are often targeted by interventions as a homogenous group, but in actuality they have varying patterns of health behavior and utilization of health services due to their proximity to services, occupation, sex, income and legal status. These MMPs, in addition to some static Thai populations, are considered ‘forest-goers’, and tend to be travel regularly to high burden areas and stay overnight deep in forest settings, sleeping under makeshift shelters. This creates a large at-risk population of both MMPs and static host communities.

3.Objective of the TOR

In order to S Support oroieck See assess s malaria knowledge, treatment-seeking behaviors and preventive practices among these different categories of MMPs in Ubon Ratchathani and Si Sa Ket, Thailand, Raks Thai Foundation seeks to contract a Consultant to design and conduct operational research. The main focus of this study is to follow up and assess LLIN and LLIHN usage, but also clearly identify behaviors and needs of, and factors relating to, hard-to-reach MMPs, particularly forest-goers, to improve service delivery. Raks Thai has maintained records of all individuals who received an LLIN or LLIHN during 2018 and 2019, which can be used to develop a clear methodology and data collection plan. By utilizing available records, and a respondent-driven sampling methodology to reach this population, we hope to provide further insight which can aid health services, community workers and policymakers in developing interventions that can better reach these populations at-risk.

4. Expectations

The expectations of these ToR are: _

To work collaboratively and productively with Raks Thai Foundation program staff and partners who are involved in planning, implementation, data collection and data analysis to develop a clear methodology and conduct research in Ubon Ratchathani and Si Sa Ket;

To analyze evidence to better understand the needs, behaviors, and factors relating to MMP and forest-goer populations’ access to malaria services, particularly relating to LLIN and LLIHN usage. This may include socio-economic conditions, net ownership and awareness of malaria among the target population;

Explore and compare findings with regional good practices to develop clear recommendations for adapting interventions within the current RAI2E grant and for future project design; and

To synthesize evidence and develop communication material that can be shared with all stakeholders following the conclusion of the study and before December 2019.

5.Scope of work

The Consultant will be responsible for planning, conducting and communicating allaspects of the operational research, in collaboration with Raks Thai. The scope of work includes the following activities:

-Review existing information from the region, and activity records by Raks Thai

-Develop methodology and associated tools according to the Objectives in order to conduct operational research in Ubon Ratchathani and Si Sa Ket provinces

-Provide any necessary training to field staff on methodology and associated tools to support with conducting the operational research.

- Conduct operational research, in collaboration with Raks Thai, to define:  

a. Effectiveness of LLIN and LLIHN and usage by MMPs and forest goer populations. b. Needs and requirements of malaria interventions to support MMPs and forest-goers

c. Trends and behaviors relating to MMPs and forest-goers, and other factors associated with malaria services including personal and socio-economic demographic details.

e) Draft a report which details the findings of operational research, and draft practical recommendations to adapt the current intervention for greater impact, and recommendations for future activity design

6. Share results and a report with Raks Thai, its partners, and key stakeholders working on malaria elimination to further discuss good practice and sustainability of the program.
7. Submit final report in Thai and English with soft file to Raks Thai.

6.Duration

The period expected for this consultancy is from 5 July 2019 to 31 December 2019 which is described in the table below:

5 Jul 2019 - 31 Dec 2019

For further information, please see the attached file.