J.2 - Task Order for Training.doc

Attachment 2

Request for Task Order Proposal Task #2 – Training in Zimbabwe *This is a firm fixed price task order.*

Task Order Title: Training on Management of Human Resources for Health in the Public Sector in Zimbabwe

Background & Purpose The Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global AIDS (DGA) supports the strengthening of Human Resources for Health (HRH) worldwide, as a critical component of a sustainable national response to HIV/AIDS. This support is provided through the President’s Emergency Plan for AIDS Relief (PEPFAR), and is based on guidance and recommendations from the World Health Organization (WHO) and other technical leaders in the field of HRH.

Achieving PEPFAR goals depends on an adequate supply of qualified health care professionals that are trained and deployed to deliver key HIV/AIDS prevention, care, and treatment services. However, worldwide the WHO estimates a global shortage of approximately 4 million doctors, nurses, and auxiliary personnel to meet basic standards of care for the world’s population. Over 1 million of these health care workers are needed in sub-Saharan Africa alone, where acute shortages and maldistribution of health workers is particularly severe.

The dynamics influencing these shortages are complex, and involve issues of pre-service education, regulatory policy and practice, recruitment, supervision and mentoring, ongoing training and continuing education, salaries and promotion, and much more. In a 2006 report, the WHO recommends a “working lifespan” approach, which systematically addresses health workforce dynamics through interventions targeted at stages in a health worker’s professional life, which include entry to the workforce, membership in the workforce, and exit from the workforce.

As the largest employer of health workers in many PEPFAR countries, Ministries of Health face tremendous challenges in managing the complex dynamics and multi-stage interventions involved in the health workforce. Moreover, in many settings, planning and management authority of the health workforce is dispersed among multiple departments and even Ministries. Training is needed by Ministry of Health officials to understand workforce dynamics, to design, implement and evaluate multi-stage HRH interventions and policies, and to navigate multiple HRH stakeholder relationships. Building the capacity of Ministries of Health to plan and manage the public sector health workforce in this way is a key PEPFAR strategy for sustainable impact on HRH.

This task order seeks support for ongoing USG efforts to build capacity in human resources for health in Zimbabwe. The Contractor will provide services to CDC in order to benefit the US Government’s broader global health efforts in Zimbabwe.

Need Recent political and economic crisis in Zimbabwe characterized by land seizures, political violence, hyperinflation, and a soaring unemployment rate of 80% has created a massive outmigration of skilled health care professionals across all cadres. The health system, once known as a ‘model’ for the continent, with highly educated health care professionals, is now in severe distress. Repeated and widespread shortages of medicine, equipment, and supplies; failure of the official currency and non-payment of health worker salaries; and critical shortages of electricity and running water causing the closing of numerous hospitals and clinics are just some of the challenges faced by a dwindling pool of health care workers.

The Government of Zimbabwe is currently finalizing a national Human Resources for Health Plan, which will project the need for health workers for the next several years and propose a strategy for meeting this need. Training and capacity-building is strongly needed among Ministry of Health officials at national, provincial, and district levels in order to effectively implement and evaluate this plan, in a context of considerable change and disruption in the broader health system.

The following training needs have been identified:

1. Training course in HRH planning and management:

Design and implement one 3-4 day training course for national and provincial Ministry of Health officials in planning and managing human resources for health. The training should be specific to the Zimbabwean context, with the goal of helping officials implement and evaluate the 2009 MOH HRH plan when published. Training should combine didactic and case-based training with small group exercises. The training should also be segmented, targeting certain content in concurrent sessions towards the particular audiences (e.g. providing discussions on finance and policy for national officials and not provincial).

Relevant officials include but are not exclusive to chief/ provincial medical/ nursing officers and laboratorians, human resource department staff, and MOH executives. USG staff in Zimbabwe working in HRH issues should also participate. District health officials will participate in future trainings.

Training should include discussion on the following HRH topics, modified from the WHO conceptual framework found at: http://www.who.int/hrh/tools/en/index.html. Additional topics and substitutions will be considered. For each topic, best practices from the region should be discussed, including how participants can adapt them to the Zimbabwe context.

Entry into the Workforce- preparing the workforce

· Planning (including discussion of finance, key stakeholders, staff allocation, sources and use of HRH data)

· Education (including discussion of supply versus demand, quality)

· Recruitment (including understanding bottlenecks, job descriptions)

· Regulation and Policy

Membership in the Workforce- enhancing worker performance

· Supervision (including discussion on mentorship, performance/ productivity, disciplinary procedures)

· Compensation (including discussion of promotions and incentives)

· Systems support

· Lifelong learning (including continuing education, in-service training)

Exit from the workforce- managing attrition

· Migration

· Career choice

· Health and safety (including discussion of HIV workplace discrimination, occupational health)

· Retirement (including discussion of retirement age)

2. Applied project in HRH

Subsequent to the training, this task order requires that each training participant be responsible for managing an applied project in HRH planning and management. The contractor is responsible for providing guidance and ongoing follow-up on the project, which should last approximately 3 months. At the end of the special project period, the contractor should bring together the course participants for discussion and sharing of progress and lessons learned.

3. Ongoing follow-up and technical assistance

The contractor should design a method for providing ongoing follow-up and technical assistance to training participants that involves at least one contact per month with each participant for the duration of this task order. This may include fostering ongoing dialogue and communication between course participants over time through meetings, site visits, phone and email.

4. Training evaluation

The contractor shall conduct two separate training evaluations. The first will be a post- award training survey immediately after the training to measure skills uptake as part of the training. The second evaluation will occur at least 6 months after the training, to examine whether the training concepts and skills are being applied in the workplace and to measure achievement of the special projects.

Specific Tasks The Contractor shall be required to perform the following tasks as specified below.

The Contractor shall provide all necessary personnel, facilities, equipment and travel to perform the following activities. The contractor is required to submit an outline of the proposed curriculum in their proposal submission for this task order.

The contractor shall design and implement a training course on HRH planning and management for national and provincial MOH officials. Specific activities and objectives include:

1. Design curriculum and course materials and implement one 3-4 day training course on HRH planning and management in Zimbabwe for 25 participants. CDC-Zimbabwe will arrange for the training facilities and equipment.

2. Provide guidance and follow-up on applied projects for each of the course participants, to take place over at least 3 months.

3. Provide ongoing mentorship and technical assistance over the period of the task order to training participants to help further integrate their learning into practice, requiring a minimum of one contact per month.

4. Conduct a Special Projects Review and Lessons Learned one day meeting with course participants at the end of the special project period, for participants to present their projects and lessons learned.

5. Conduct a post-training evaluation survey to assess skills uptake as part of the 3 day training. Conduct a second evaluation at least 6 months after conclusion of the training, to assess the extent to which training concepts and skills are being translated into the workplace and completion of the special project.

Period of Performance Twelve (12) months from the date of award.

Deliverables

Performance-Based Matrix

Surveillance "Incentives" Positive or Negative

and observation.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

Past Performance and Evaluation to Determine whether or not to Exercise Future Options.

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