Terms of Reference to develop NRCS Emergency Health Preparedness and Response Framework

Terms of Reference to develop NRCS Emergency Health Preparedness and Response Framework

Comprehensive Community Based Health Program (CCBHP)

1.   Background 

Sudden onset of disaster and emergency impose great impact in population and environment in many ways. Since centuries, heath emergencies have been emerging as a challenge in the field of public health with the substantial health burden, either directly to the population or to the health system of the country and compromising the primary health needs. The concept of disaster epidemiology guides to improve preparedness and response and contributes to reduce the impact of such scenarios. As with other health and social problems, the impact of health crises on vulnerable groups increases when the country is less prepared with limited capacity.

The emerging and re-emerging diseases (plague of 17th and 18th century, Smallpox in 1520, Spanish Flu in 1918-19, influenza pandemic A H1N1/ H5N1 on 2009-10 and Ebola outbreak in 2015-16) represented serious threats, against which countries have developed some protocols to strengthen their resilience. The ongoing unprecedented COVID-19 pandemic is an alarm to the world highlighting the possible impact of outbreaks in health and other social determinants of health 1. 

Nepal is presently under the stretch of dual burden of diseases, where communicable diseases are prevalent causing outbreaks in a context of rapid urbanization and impact of globalization. The impact of climate change and increasing number of droughts, floods, hailstorms, landslides and crop diseases is mostly affecting the livelihoods of the socio-economically marginalized population 2.  Nepal with frequent flood, landslides and other natural disasters, is prone to waterborne diseases outbreaks and seasonal outbreaks like Dengue, Malaria. With other national health priorities, the ongoing COVID-19 pandemic have alerted the government to strengthen the preparedness and response for emergency health scenarios.

NRCS, as an auxiliary to Government of Nepal, is a major humanitarian actor in the country having worked for more than 50 years in disaster risk management including preparedness and response. NRCS has been responding to disasters in the country, mainly floods, landslides, fires and water related diseases every year. NRCS has nationwide coverage with newly established provincial structure and its network of District Chapters (DCs) extended in each of the 77 districts of the country and work through more than 1,400 Sub-Chapters and Cooperation Committees and more than one million members including Junior/Youths around the country. 

NRCS response to Nepal earthquake 2015 has been recognized as one of the significant inputs supporting government in response, relief and rehabilitation phase. NRCS’ Disaster responses are guided by the NRCS’ Disaster Management strategic framework, which guides the National Society for overall cycle of disaster and act to save lives and alleviate human sufferings, meanwhile meeting the organizational objectives. NRCS also have in place an earthquake contingency plan. As having a special role in national disaster and emergency response, NRCS has identified the gap to strategically frame the mechanism of emergency health scenarios. 

NRCS Emergency Operation Center Unit (EOC) is an institutional mechanism that gets activated under the decision of NRCS Senior Management Team to have timely and effective response on any emergency scenario nationwide. The operation unit functions as central unit for overall response coordinating all 77 District chapters and NRCS Networks. With evolving figures of health emergency and disaster globally, it is crucial for NRCS as an identified actor to be prepared with essential policies and plans in place to respond to various forms of emergency. Outbreak of Dengue, diarrhea, cholera and now COVID-19 Pandemic are examples of health crises that reinforces the need for NRCS to enhance their capacity on health emergency and have a standard framework. As per the needs, NRCS has been responding to diseases outbreak as per their initial assessments or to support the response actions of the Nepal government like Community actions in Dengue affected districts in2019 and past involvement in Jajarkot diarrheal outbreak in 2008. 

Government of Nepal has defined the Health Emergency Operation Center(HEOC) as a supportive body to the National Emergency Operation Center(NEOC) to lead for health in emergency contexts. Epidemiology and Diseases Control Division (EDCD) under the Department of Health service serves as a key unit to closely measure the pattern of diseases and health events for early warning and response. The mechanism is in place to intervene in case of different diseases and health specific response, with the latest being COVID-19 preparedness and response plan. Also, the national disaster management framework specifies the areas of health to be addressed in any disaster context. NRCS has been closely working with the GoN bodies along with other stakeholders in the sector and supporting the response actions. NRCS Health Service Department is recognized bythe Health and Nutrition Cluster and its members participate in the cluster meeting regularly. NRCS has an agreement with HEOC on deployment of Red Cross Emergency Clinic (RCEC) and members of their trained roster and have been closely working with GoN for COVID-19 response.

NRCS 7th development plan 2016-2020 is in its final year and the process of developing the 8th development plan aligned with IFRC strategy 2020-2030 is in progress. NRCS has its Disaster Management Strategic Framework 2010-2015, which is also in process of being updated and reviewed. NRCS Disaster Risk Reduction strategy 2019-2025 is another strategic document that guides NRCS preparedness and response actions. The documents give a broad idea over NRCS strategy to respond to any disaster scenario and the essential elements for mitigation in various sectors. In addition, NRCS’ emergency WASH policy, with established fund for emergency WASH response, guides essential WASH interventions to respond quickly. However, in the current context with the impact of climate change and the increasing threat of emerging and reemerging diseases, NRCS’ emergency preparedness and response framework for "Health emergencies" must be developed. NRCS HSD Operational Plan review 2019 also highlighted the need to have the NRCS EHPRP emergency health and health in emergency contexts to be well addressed and institutionalized in NRCS Contingency plan. Thus, this framework will guide and add to NRCS timely and effective emergency health response actions. 

CCBHP is three years bilateral project implementing by Nepal Red Cross with the financial and technical support of Canadian Red Cross. The project has been designed to enhance the health and wellbeing of most vulnerable communities by providing basic health and emergency health services. 

1 https://www.who.int/csr/don/archive/year/en/ world Health Organization, Emergency Preparedness and Response

2 http://drrportal.gov.np/uploads/document/1321.pdf/Nepal Disaster Report 2017

2.   Objective

The objective of the consultancy is to develop NRCS’ Emergency Health Preparedness and Response Framework in English aligned with the NRCS’ strategic development plan, NRCS’s Health Strategy, government health emergency strategies, IFRC health and care framework along with international emergency health strategies. The strategy will be prepared in consultation and coordination with NRCS key stakeholders (GON/MOHP/EDCD, PNS, IFRC UN agencies) reflecting the realities and unicity of the country context

3.    Responsibilities/tasks

3.1   Consultant

• The consultant will have discussions with the MoHP bodies and will document the process (data and information collection) when relevant in the EHPRP. The consultant will do an in-depth study of the GoN Emergency health policies and guidelines and will include it in the discussions and will ensure NRCS EHPRP is in line with them.  
• Develop an inception report including a detailed plan aligned with the methodologies briefed in the ToR by identifying concrete data and overseeing major strategies, methodologies and processes to complete the assigned work.
• Finalize and agree on the methodology in consultation with relevant members of NRCS, MOHP/NHEOC, PNSs to collect the information and data to be considered in developing the framework
• Identify and conduct desk review for all relevant existing documents and resources from NRCS, IFRC, GoN, WHO, and other well recognized public health platforms. 
• To lead  the development of NRCS’ Emergency Health Preparedness and Response Framework (EHPRF) with close consultation with the NRCS and participatory manner mainly by national actors.  The consultant would lead and coordinate with substantial technical inputs that would come from other actors. The document should be aligned with the NRCS’ strategic development plan, NRCS disaster management policy framework, GoN strategies and plans, international strategies and any relevant Red Cross guidelines.
  • Organize consultations with NRCS staff and volunteers, IFRC and the PNS to collect their inputs for the development of the EHPRF
  • Conduct workshop(s) with the same stakeholders to receive their feedback on the draft documents which will be considered for improvement
  • Analyse, consider and include (when relevant) the feedbacks and inputs provided by the different stakeholders.
  • Ensure that the developed document is in line with NRCS policies and strategic documents, GON/MOHP strategies and RCM principles (reference document indicated below)

3.2   NRCS 

• Communicate internally to any authority as necessary 
• Provide all reference documents to consultant
• Provide information/inputs during any consultative meeting/interview 
• Join any discussion/meeting with HEOC/EDCD as required during the process.
• Review and provide inputs on the document and monitor the progress being made
• Approve the final version of the framework for consideration in the 8th NRCS development plan document

3.3   Canadian Red Cross

• Participate in any key informant interview, meeting, workshop, as required
• Reviewand provide technical inputs on the document
• Make necessary payments to the consultant as per agreement document signed between IFRC/Canadian Red Cross and the consultant.  

4   Methodology 

The consultant will employ Qualitative and qualitative methods to gain information and perspective from relevant documents and selected informant and stakeholders. The consultant is requested to propose in detail the methodology they are planning to us to complete the assignment. Methods should include, but are not be limited to: 

• Desk review of key documents, including strategic documents mentioned below.
• Literature search and review of emergency health strategies/frameworks at global and national levels.
• Interviews (Key Informant Interview –KII)/Focus group discussions (FGDs) – structure/semi-structure/in-depth – with NRCS key staff from different department, Governance team, IFRC and other RC movement partners. 
• KII with GoN relevant stakeholders (HEOC/EDCD).
• Facilitate workshops/conduct interactive discussions among NRCS teams. 1 workshop with all the teams and participants mentioned above.
• Observation of some key initiatives 

5   Tools: (To be prepared by Consultant with consultation with IFRC/Partners//NRCS)

• Interview questions /checklist
• Focus group discussion guide/checklist

6  Deliverables and the timeline of the assignment

Duration of assignment, maximum 37 working days spread over two months. The specific timeframe will be agreed in joint consultation with Canadian Red Cross in consultation with NRCS’ Health Service Department and detailed throughout the assignment. It is expected that the consultant develops an action plan at the beginning of his assignment that will be approved by Evaluation Management Committee.

Evaluation Management Committee: The evaluation management committee will comprise of CCBHP Technical Advisory members, National Office (NO) CRC staff, representatives from the NS country team.  The NO CRC staff will include a CRC-HQ Evaluation Manager, Head of Region for Africa, Program Coordinator, CRC-HQ Health Advisor, CRC-HQ PGIE advisors, and CRC-HQ Senior PMER advisor.

The consultant will report, to a designated technical focal point in Nepal. 

The Evaluation Management Committee will receive regular updates and will review and approve final deliverables to ensure that they uphold the expected quality of this work.  This group holds decision making authority on all final products or necessary modifications to the proposed plans. Other stakeholders may be consulted as deemed necessary but will not have final decision-making authority. 

Coordination: Once the selected consultant start his/her work, he/she is required to maintain regular weekly communications and coordination with the Designed technical focal point in Nepal. 

6.  Quality & Ethical Standards

The consultant will sign and adhere to the IFRC Code of Conduct and comply with the following

• Participation: Stakeholders should be consulted and meaningfully involved in the evaluation process when feasible and appropriate.
• Collaboration: Collaboration between key operating partners in the evaluation process improves the legitimacy and utility of the evaluation.

It is also expected that the consultant will adhere to:

1. The seven Fundamental Principles of the Red Cross and Red Crescent: 1) humanity, 2) impartiality, 3) neutrality, 4) independence, 5) voluntary service, 6) unity, and 7) universality. Further information about these Principles can be obtained at: www.ifrc.org/what/values/principles/index.asp

7   Qualifications or specialized knowledge/ experience required

The consultancy is open to individual and organisations that have proven sound experience related to the development of emergency/Health Sector plans, guidelines, frameworks and strategies.

• University postgraduate degree in relevant field of study (e.g. Public Health, disaster management, global health, International health and Regulation, Epidemiology). One team member with Ph.D. in health/ Epidemiology or in related another disciple will be an asset. 
• Minimum 10 years’ experience in developing policies and strategies in Emergency health preparedness and response, disaster /crisis management, Epidemiological study/research and/or related discipline. 
• Solid experience in development of organisations' strategic documents, preparedness and response plans preferably in health. Proven experience of leading at least three such strategic documents.
• Good knowledge of Nepal healthcare system and common emergencies, with demonstrated practical working experience or research.
• Experience of effective interaction with local non-government organizations, government departments, and international organizations
• Relevant experience in analyzing qualitative and quantitative data
• Excellent analytical and writing skills in English.
• Fluency in Nepali and English with ability to convey ideas clearly in writing and orally.
• Successful experience of working/supporting RCRC in development of health/disaster related plan, guidelines and strategies is desirable.

8   Other Terms:

The consultant may have to adjust, modify their work schedule plans as per local situation in consultation with Canadian Red Cross. Full cooperation and support will be extended to the consultant. All decisions regarding the adjustment in schedule, information collection method or any other change will be finalized after consultation between the consultant and Canadian Red Cross.

9   Reference documents

• NRCS’ 7th developmental plan/8th developmental plan (on process documents)
• Nepal Red Cross Society Disaster Management Policy Strategic Framework.
• NRCS’ Risk Reduction Strategy Framework 2019-2025
• NRCS’ Health Strategy 2016-2020
• Emergency WASH Policy 2010
• IFRC strategy plan 2020-2030
• National Health emergency response plan.
• COVID-19 preparedness and Response guideline /Nepal
• National Preparedness and Response Plan for Acute Gastroenteritis/ Cholera Outbreaks in Nepal.
• Infectious Disease Control Guideline, Epidemiology and Disease Control Division 2073 BS
• Other emergency health preparedness and response plan.

10   Financial Proposal 

The financial proposal should be submitted in Nepalese Currency (NPR) Only. 

11   Required Documents/Certificates with the proposal: 

The documents/certificates that should be submitted/attached with your offer are: -

• Acknowledgment of ToR. (Please attach the signed copy of these Terms of Reference with your offer)
• Company profile (in case of individual or team of people latest curriculum vitae).
• At least one certificate of similar kind of experience.
• Copy of VAT/PAN registration certificate.
• Incase of individual copy of citizenship or passport
• Copy of Business Registration/renewal certificate, if applicable. 
• Copy of latest TAX clearance certificate

HOW TO APPLY

Interested individual and organization should submit the following documents to Ms. Aliza Baidya at Aliza.Baidya@ifrc.org no later than 17 January 2021, 17:00 HRs NPT. Please be informed that the Technical and financial proposal must be submitted as separate document.  The incomplete proposal in all respect and proposals submitted after deadline will not be considered. 

1. Submit a technical, financial, and timeline proposal demonstrating a thorough understanding of this ToR
2. Submit detailed CV and application letter showing why you are most suitable for undertaking the consultancy
3. Submit example of any relevant previous work (at least one)
4. Submit names and contacts for 3 references 

We thank you in advance for understanding that only short-listed candidates will be contacted for the next step in the application process.