For Conducting Comprehensive Data Quality Audit among Health Facilities supported by EGPAF Mozambique



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REQUEST FOR PROPOSALS #03485 For Conducting Comprehensive Data Quality Audit among Health Facilities supported by EGPAF Mozambique in support of ELIZABETH GLASER PEDIATRIC AIDS FOUNDATION (EGPAF) Firm Deadline: 5:00 pm Eastern Standard Time May 14, 2014 The Elizabeth Glaser Pediatric AIDS Foundation, a non-profit organization, is the world leader in the fight to eliminate pediatric AIDS. Our mission is to prevent pediatric HIV infection and to eliminate pediatric AIDS through research, advocacy, and prevention and treatment programs. For more information, please visit http://www.pedaids.org. BACKGROUND: EGPAF is supporting the health care delivery system in Mozambique since 2004. Initially EGPAF was mostly focusing on PMTCT and ART with funding from UNICEF, USAID and PEPFAR. In 2006, EGPAF was funded by CDC to support delivery of comprehensive HIV prevention, care and treatment programs in 4 provinces in Mozambique, namely Cabo Delgado, Nampula, Gaza and Maputo. After 5 years of implementation, CDC decided to adopt a strategy aiming at transitioning the work of International NGOs to local organizations while providing only some technical support. Fundação Ariel Glaser was therefore created as a local affiliate of EGPAF in Mozambique. Finally CDC strategy was revised to allow EGPAF and Fundação Ariel Glaser to evolve in parallel in Mozambique. The two organizations have a budget of almost US$ 30 million per year. EGPAF and its local Mozambican affiliate are now supporting the Ministry of Health to implement PMTCT services at more than 290 sites and HIV care and antiretroviral treatment (ART) services at 72 sites. In 2009, EGPAF initiated sub-grants to health districts and autonomous health facilities to provide financial support for the integration of HIV clinical services within strengthened primary care services at the provincial and district levels and to increase local capacity to manage funds. In January 2011 in coordination with the MOH and two Provincial Directorates of Health, EGPAF added a Performance-based Financing (PBF) component to the costreimbursement sub grants, in two provinces, Gaza and Nampula, with the objective of improving the quality and quantity of HIV and MCH clinical services. Payments for performance are based on the quantity of outputs (through case-based remuneration). The EGPAF PBF model focuses on increasing utilization and quality of care for HIV/AIDS and maternal and child health (MCH) outcomes. As a PEPFAR implementing partner, EGPAF facilitates a rigorous on-going data collection system on HIV clinical services, including electronic databases in most ART providing facilities as well as paper-based systems in peripheral PMTCT sites. Consistent with PEPFAR requirements, EGPAF has supported collection and verification of data on HIV clinical services, including PMTCT, ART, Care, testing and counseling, alongside with the expansion and rollout of the service delivery capacity. However, 1

assuring an optimal quality of data has been an ongoing challenge. EGPAF has put in place a Data Quality Assurance strategy, which includes conducting regular internal data quality assessments. These assessments have contributed towards improving the quality of data and thus the reports generated and submitted to the Ministry of Health as well as the donors. Accordingly, the latest internal data quality assessment was done in October2013 across 78 PMTCT (and/or) ART providing sites, indicating an acceptable quality of data. However, it was decided to further verify and validate the internal DQA results with a comprehensive external audit. We anticipate utilizing the findings to identify data quality issues and resolve these challenges as appropriately as possible and eventually strengthen the overall monitoring and evaluation system. EGPAF Mozambique, therefore, intends to engage (an) external auditor to conduct a comprehensive data quality audit (DQA) among representative sample of facilities providing ART and/or PMTCT services in Gaza and Nampula Provinces. EGPAF anticipates review of selected core PMTCT (and/or) ART indicators. Both clinical and performance indicators will need to be selected to address the performance based financing (PBF) approach of EGPAF Mozambique. PURPOSE OF THE DATA QUALITY AUDIT: The primary purpose of the data quality audit is to assess whether the data reported by health facilities is accurate. The audit is also intended to assess concordance of data reports from PBF invoices and routine data collection systems. The secondary purpose of this exercise is to assess EGPAF Mozambique s overall data management system with particular emphasis on the assessing the quality of data on the source documents as well the reports generated and submitted to donors, using standard data audit tools. The audit findings will facilitate improvement of EGPAF/Mozambique monitoring systems. The DQA is expected to highlight strengths and weaknesses of EGPAF/Mozambique data management systems. In summary, the DQA focus will be to: a. Assess the quality of data (reports), in terms of its concordance with the source registers submitted by EGPAF/Mozambique thru standard data quality parameters such as its validity, reliability, timeliness, precision and integrity. b. Estimate the margin of error of reported data vis-à-vis source data, by district and by province c. Assess the various data collection, processing and management systems implemented by EGPAF/Mozambique. d. Assess the flow of data from the initial collection point, to all subsequent higher levels of reporting. e. Identify areas of potential vulnerability that affect general credibility and usefulness of the datasets f. Recommend measures to address any identified weaknesses in the data submitted by EGPAF/Mozambique as well as the M&E procedures and systems in place CONTRACTOR DELIVERABLES: The DQA Team will provide the following deliverables: a. DQA protocol describing objectives, methodologies, tools, timelines b. Consultative workshop for EGPAF M&E unit on the methodologies and tools to be used in the DQA to be done in Mozambique c. Debriefing with EGPAF/Mozambique senior management and staff on the DQA 2

findings and recommendations d. Two draft report versions for comments and feedback to EGPAF (Mozambique Country Office and Head Quarters in Washington) e. The DQA should include a summary of all weaknesses found; the significance of the weaknesses, and recommendations for addressing the findings. f. The DQA results shall be presented in a draft report at a full debriefing meeting with EGPAF/Moz. The final report shall be submitted to EGPAF/Mozambique in hard copy and electronic format: two hard copies and a CD-ROM METHODOLOGY: The DQA team will develop a protocol outlining their methodology, processes, steps and tools to be used in the audit. The DQA will mainly be conducted through site visits using a standardized tool. The team will analyze selected indicators at each stage of the data management system (from collection through reporting) and evaluate it for validity, reliability, integrity, precision, and timeliness. This will involve: a. A desk review of quarterly, semi-annual and annual reports submitted to CDC in 2013. b. Interviews with senior management (SM) team members as well as staffs at the health facilities to better understand the routine M&E system including the indicator definitions, data collection needs and the context in which these data and the indicators are reported c. Verification of the reports by recounting of the data from the source registers and/or patient files for its concordance at each of the selected health facilities. d. Verify exactly where data are stored and how reports are filed e. An overall analysis of EGPAF/Mozambique M&E system f. The DQA shall sample Health Units in the four Provinces of Cabo Delgado, Nampula, Gaza and Maputo Provinces in Mozambique g. The revision of data shall consider the period January 2011 to December 2013 a. In each HU, a sample of the 21 PBF indicators and CDC indicators for the review period needs to be contemplated on a Quarterly basis. The DQA is intended to be a 3 rd party audit of data, and therefore the audit team is expected to adhere to the principles of independence from all parties, including EGPAF. CONTRACTOR QUALIFICATIONS: The Contractor shall propose a DQA Team composed of individuals with the following suggested qualifications: a. A minimum of five years relevant professional experience in M&E, strategic information management, Data Quality Audit or other relevant fields b. Knowledge of PEPFAR funded M&E, reporting requirements, and DQA tools and standards a plus c. A proven experience with conducting DQAs preferably with institutions in developing countries d. Excellent report writing and presentation skills e. Working knowledge in both written and spoken Portuguese - this is a requirement to bid on the RFP. 3

LOGISTICS LOGISTICS The DQA team shall work at EGPAF/Mozambique offices in Maputo, but will work closely with M&E unit, SM team, and field coordinators. Depending on the contractual arrangements, EGPAF/Mozambique will provide office space, including access to computer network or web-only access, telephone, fax, photocopier and any other necessary equipment. EGPAF/Mozambique vehicles will be available for hotel-officehotel transfers, field travel on request and, as available, for after hours and weekends for purposes related to this work assignment only. KEY CONTRACT TERMS: All deliverables provided to the Foundation must be furnished for the use of the Foundation without royalty or any additional fees. All Materials will be owned exclusively by the Foundation. Contractor will not use or allow the use of the Materials for any purpose other than Contractor s performance of the Contract without the prior written consent of the Foundation. EVALUATION CRITERIA AND SUBMISSION REQUIREMENTS: All proposals will be evaluated against the following Evaluation Criteria. Each proposal must contain the items listed in the Submission Requirements column in the following chart. Please submit your Submission Requirements in the order that they appear below. The Foundation will select the Contractor that provides the Best Value to the Foundation based on the below criteria. Evaluation Criteria Submission Requirements Weight 1. Past performance of similar work 2. Proposed Methodology and Approach 1. 3 professional references from similar past projects with phone and email contact information and one or more examples of prior similar work 2. A maximum 5-page written proposal explaining the proposed methodology and approach 20% 25% 3. Timeframe of implementation 3. Estimated hours, timeframe with deliverables, final delivery date including a detailed timeline (See Sample Detailed Schedule). The DQA is scheduled to be conducted in June/July 2014. 4. Total fixed price 4. Total fixed price for all activities 15% 20% 5. Qualifications of proposed individuals 5. CV/Resume of proposed individuals to work on this project and 2 references per individual 20% Total 100% SAMPLE DETAILED SCHEDULE 4

Item Task Duration 1 Travel to Mozambique 1 days Develop and submit DQA protocol 2 days before hand 2 DQA Workshop (preparation & workshop) 1 days 3 Pre-desk review of background documentation 1 days 4 Meet with EGPAF/Mozambique SM Team 0,5 day 5 Travel to Cabo Delgado, Gaza, Maputo and Nampula to 31 days assess data sources 6 Report writing (final report in country) 3 days 7 Debriefing meeting 0,5 day 8 Depart Mozambique 1 day Total 31 days PROPOSED TIMELINE: The DQA is scheduled to be conducted in June/July 2014. EGPAF/Mozambique anticipates the assessment shall be conducted within a period of four weeks. The tentative schedule is as follows: DATE: April 18, 2014 Release of RFP DATE: April 28, 2014 Submission of Technical Inquiries & Contractual Inquiries: Christa Moore, Senior Awards and Compliance Manager, cmoore@pedaids.org and Emelie Bailey, Awards and Compliance Officer, ebailey@pedaids.org No phone calls please. DATE: May 5, 2014 Question and Answer Response Document posted on EGPAF website at http://www.pedaids.org. DATE: May 14, 2014 - Completed proposals must be delivered electronically by the deadline mentioned on page one to: Christa Moore, Senior Awards and Compliance Manager, cmoore@pedaids.org with a cc to Emelie Bailey, Awards and Compliance Officer, ebailey@pedaids.org DATE: May 30, 2014: Contract executed and Services begin. Please note it is our best intent to comply with the above timeline but unavoidable delays may occur. ADDITIONAL INFORMATION All proposals and communications must be identified by the unique RFP# reflected on the first page of this document. Failure to comply with this requirement may result in non-consideration of your proposal. Any proposal not addressing each of the foregoing items could be considered non- 5

responsive. Late proposals will be rejected without being considered. This RFP is not an offer to enter into agreement with any party, but rather a request to receive proposals from persons interested in providing the services outlined below. Such proposals shall be considered and treated by the Foundation as offers to enter into an agreement. The Foundation reserves the right to reject all proposals, in whole or in part, and/or enter into negotiations with any party. The Foundation shall not be obligated for the payment of any sums whatsoever to any recipient of this RFP until and unless a written contract between the parties is executed. Equal Opportunity Notice. The Elizabeth Glaser Pediatric AIDS Foundation is an Equal Employment Opportunity employer and represents that all qualified bidders will receive consideration without regard to race, color, religion, sex, or national origin. ETHICAL BEHAVIOR: As a core value to help achieve our mission, the Foundation embraces a culture of honesty, integrity, and ethical business practices and expects its business partners to do the same. Specifically, our procurement processes are fair and open and allow all vendors/consultants equal opportunity to win our business. We will not tolerate fraud or corruption, including kickbacks, bribes, undisclosed familial or close personal relationships between vendors and Foundation employees, or other unethical practices. If you experience of suspect unethical behavior by a Foundation employee, please contact Doug Horner, Vice President, Awards, Compliance & International Operations, at dhorner@pedaids.org or the Foundation s Ethics Hotline at www.reportlineweb.com/pedaids/ Any vendor/consultant who attempts to engage, or engages, in corrupt practices with the Foundation will have their proposal disqualified and will not be solicited for future work. REFERENCE DOCUMENTS: ANNEX 1. RECOMMENDATIONS FOR CONDUCTING DATA QUALITY ASSESSMENTS ANNEX 2. Data Quality procedures for PEPFAR clinical partners ANNEX 3. PEPFAR Indicator reference guide (See indicators for PMTCT, CLC, ART, CTATS, CT Clinical) ANNEX 4. List of PBF Indicators 6

ANNEX 1. RECOMMENDATIONS FOR CONDUCTING DATA QUALITY ASSESSMENTS 1. Individuals conducting the DQA should describe in detail the methodology that will be used to conduct the DQA. This is required for each indicator. This information should be provided before the DQA is conducted. 2. The DQ assessors should make sure that they understand the precise definition of the indicator. 3. DQ assessor should have a copy of the methodology for data collection in hand before assessing the indicator. Each indicator should have a written description of how the data being assessed are collected. 4. Each field M&E Advisers should have a copy of the method of data collection in their files and documented evidence that they are collecting the data according to the methodology. 5. Assessor should record the names and titles of all individuals involved in the assessment. 6. EGPAF will provide documented evidence that it has verified the data that has been reported to CDC. These documents will have information on process/person conducting the verification/field visit dates/persons met/activities visited, etc. demonstrating that data reported to CDC was verified. 7. The DQ assessor should be able to review files/records against the methodology for data collection laid out. Any data quality concerns should be documented 8. Storage of data is critical to this process. The assessor should document all observed weaknesses in the files/record keeping associated with the indicator being reviewed. 7