Task Order for Zimbabwe - Training.doc

Appendix II: Sample Task Order for Zimbabwe

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

Please base all costs associated with logistics (airfare, lodging, per diem) on U.S. government approved rates for the country where work is conducted. U.S. Government international per diem rates are established and maintained by the U.S. Department of State’s Office of Allowances. Information on countries is available at: http://aoprals.state.gov/content.asp?content_id=184&menu_id=178 Period of Performance: Up to 12 months. Work will be expected to begin no later than 4 weeks after the task order is awarded.

I. Background & Purpose The Centers for Disease Control and Prevention Division of Global AIDS (CDC/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.

The services described below are requested by CDC Atlanta, in collaboration with CDC-Zimbabwe. The specific request seeks support for ongoing USG efforts to build capacity in human resources for health in Zimbabwe. The Contractor will provide such services to CDC in order to benefit the US Government’s broader global health efforts in Zimbabwe.

II. 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. What was once known as a ‘model’ health system 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 is to effective 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. A training course in HRH planning and management:

This task order requests the design and implementation of a 3-4 day 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 towards the relevant audience (e.g. providing discussions on finance and policy for national officials and not provincial). One suggested method for segmenting the training is to have some joint training sessions with both national and provincial staff and some concurrent sessions of each group.

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 be invited to attend. District health officials may be included in subsequent task orders, but are not included in this task order to allow for adequate targeting of training.

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 and 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 requests 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.

3. Ongoing follow-up and technical assistance

The contractor should design a method for ongoing follow-up and technical assistance of 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 or email.

4. Training evaluation

The contractor should conduct an evaluation of the training, both immediately after the training, in the form of a post-training survey, and after completion of the applied project and at least 6 months after training, to examine if training concepts and skills are being applied in the workplace.

III. Specific Tasks

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

a. Contractor Responsibilities

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 proposed curriculum as part of the bid for this task order.

The contractor is requested to 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 a 2-4 day training course on HRH planning and management in Zimbabwe.

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.

4. Evaluate the training 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.

IV. Reporting Requirements

The Contractor shall provide deliverables in accordance with the delivery schedule in section VII, below, as well as a quarterly progress report to the CDC/DGA project officer in Atlanta and to the USG staff in Zimbabwe who has been assigned as the local technical monitor. This quarterly progress report will not exceed one single-spaced type-written page. It will include a brief narrative account of key activities accomplished and activities planned for the next month, as well as any challenges encountered.

V. Period of Performance

Up to 12 months from date of task order award, contractor shall provide a schedule for activities and tasks specified on this task order.

VI. Government Responsibilities:

CDC (or USG mission) staff based in Zimbabwe will serve as technical monitors for this task order. As such, they will be the main points of contact for the Contractor for administrative and technical issues, and for the review and approval of all plans. CDC staff in Atlanta will provide additional technical input on an as-needed or as-requested basis. A staff person from the sponsoring USG agency in Zimbabwe will serve as the primary point of contact for the Contractor and/or Consultant while in Zimbabwe. However, neither CDC nor the USG mission will provide any logistical or office support to the Contractor and/or Consultant while in Zimbabwe.

VII. Deliverables

The Contractor shall furnish the CDC/DGA project officer in Atlanta, and the USG technical monitor in Zimbabwe, with the following items on the indicated dates.

VIII. Minimum Personnel Qualifications/Requirements

The Contractor shall one or more subject matter experts to serve as consultants to the NBTS (and/or MOH) of Zimbabwe during the period of performance for this task order. This consultant must have advanced academic training and/or professional experience in the technical areas related to human resources for health (including, but not limited to, HRH planning and management, HRH policy and regulation, health worker education and training, civil service / health sector reform, managing health worker performance and/or supervision) The consultant must have at least 5 years of demonstrated experience in the field of HRH, with specific experience in technical assistance for planning and management and working with national and provincial Ministry of Health officials. The consultant must be prepared to travel to Zimbabwe at least four times during the period of performance.

IX. Project Officer and Technical Monitor

The global project officer based at CDC/DGA in Atlanta will respond to questions about the Contractor’s global contract and/or any specific task order.

One technical monitor will be based in the CDC office in Zimbabwe. The technical monitor will serve as the primary point of contact for this task order and will respond to specific questions from the contractor. Additional technical advice may be solicited from CDC/DGA Atlanta by the technical monitor.