Solicitation.docx

Solicitation Number: SOL 72036718Q00002

Closing Date: December 15, 2017

USAID Nepal seeks to contract a team consisting of one international consultant supported by one national consultant carry out a study on factors that contribute to the stock out of essential medicines in Government of Nepal (GoN) health facilities.

The successful consultant will be assigned under a purchase order to carry out a study on factors that contribute to the stock out of essential medicines in Government of Nepal (GoN) health facilities. Stock out of essential medicines is a critical impediment for ensuring good quality of care. The findings from this study will be useful to MoH, USAID and other partners in identifying the root causes that negatively impact the performance of the supply chain system to identify and implement corrective actions.

The mission will negotiate compensation for this assignment. The successful contractor will be assigned under a Purchase Order (PO) for the deliverables as described in the Statement of Work. If awarded, the Contractor must complete deliverables within the final negotiated cost and dates.

If you are interested, please provide USAID/Nepal Executive Office (EXO) with your quotation at your earliest opportunity, but no later than Friday, December 15, 2017.

SOW outlines what USAID/Nepal expects, to be accomplished; however, future minor adjustments may be incorporated. The final SOW will be included in the official purchase order. This solicitation in no way obligates USAID/Nepal to award a PO/Contract nor does it commit USAID/Nepal to pay any cost incurred in the preparation and submission of the quotation. Do not incur any expense or begin work until notified that a contract has been awarded to you, in writing, by the Contracting Officer. Please send an email to Srijana Rana srana@usaid.gov if you have any questions regarding this announcement.

Please see the Statement of Work (SOW) and other attachments in the continuation pages.

TITLE: FACTORS CONTRIBUTING TO THE STOCK OUT OF ESSENTIAL MEDICINES IN GOVERNMENT OF NEPAL HEALTH FACILITIES PURPOSE/OBJECTIVE: The purpose of this statement of work is to obtain services from a local Contractor to carry out a study on factors that contribute to the stock out of essential medicines in Government of Nepal (GoN) health facilities. Stock out of essential medicines is a critical impediment for ensuring good quality of care. The findings from this study will be useful to MoH, USAID and other partners in identifying the root causes that negatively impact the performance of the supply chain system to identify and implement corrective actions. The supply chain system is one of the highest priority areas identified in the Nepal Health Sector Strategy 2016-2021 and an area of great investment for the USAID/Nepal Health Office.

STATEMENT OF WORK

1. BACKGROUND

1.1 Policy Context

Nepal has made remarkable progress in improving the health outcomes of its people, as demonstrated by rapid declines in newborn, infant, under-five mortality and maternal mortality rates over the last 20 years. This improvement is due to increased access to health services, increased investment in the health sector, and delivery of high impact interventions at both the community and facility level. Basic health care is free in Nepal. In addition, there is a demand side-financing scheme for maternity services where women receive transportation allowance for using professional antenatal and delivery services. Health insurance was initially implemented in three districts (Kailali, Baglung and Illam) in 2015 with a plan to expand nation-wide by 2021.[footnoteRef:1] Despite these improvements across the public health sector, out-of-pocket spending (OOPS) for health is high (48 percent) in Nepal.[footnoteRef:2] [1: Ministry of Health. 2017. Social Health Security Program (Health Insurance) Government of Nepal. Social Health Security Development Committee. Ppt slides.] [2: Central Bureau of Statistics, Nepal Living Standard Survey (NLSS) 2013/14]

The Nepal Health Sector Strategy (NHSS) 2016-2021 guides priority activities in the health sector and one of the national goals in the NHSS is to improve the efficiency, economy and transparency of procurement and supply chain of essential medicines and equipment. Essential drugs and commodities constitute one of the six building blocks of a health system. The Logistics Management Division (LMD) under the DoHS of the MoH is responsible for procuring, storing and distributing essential medicines, commodities and equipment for government health facilities. LMD is also responsible for the repair and maintenance of bio-medical and cold chain equipment, medical instruments and transportation of a variety of medical commodities.

The MoH has a network of two central stores at Teku and Pathalaiya, five regional medical stores (RMS) in Biratnagar, Hetauda, Butwal, Nepalgunj and Dhangadhi, 75 district medical stores at district public health offices (D/PHOs) and over 4,000 health facilities, which include 207 primary health care centers (PHCCs), over 3,500 health posts (HPs), and more than 150 Urban Health Clinics that serve diverse communities across Nepal’s terai, hilly, and mountainous zones. In addition, there is a cadre of over 50,000 Female Community Health Volunteers (FCHVs) that also distribute selected medicines such as iron tablets and oral rehydration salts at the community level.

1.2 Supply Chain System

The supply chain system of Nepal is based on a hybrid push and pull model where procurement of essential medicines and supplies is primarily conducted at the central level. The regional and district stores receive budgets for procurement of medicines and supplies that the central stores will not procure. The budget is shared annually and fluctuates from year to year. The central stores push medicines and supplies to the regional and district stores, and the regional medical stores further push medicines and supplies to their respective district stores at the D(P)HOs. The DPHOs distribute medicines and supplies to their respective primary health care centers and health posts through a mix pull and push system. PHCCs and HPs provide selected medicines to the FCHVs.

Nepal’s public health supply chain system has a number of challenges, from frequent staff turnover to a particularly difficult geography. These issues have been aggravated by a number of natural and policy related challenges, including the earthquake of 2015, blockades at the border of India resulting in fuel shortages, and increased activity by the Commission for the Investigation of Abuse of Authority (CIAA) leading to a year-long lapse in central level procurement of medicines.

1.3 Essential Medicine List (EML)

The essential medicine list (EML) was last updated in 2016 and is available publicly on the website of the Department of Drug Administration (DDA) of the MoH. There are currently 321 medicines on the EML, and out of these 70 medicines are free in the public sector. The EML is revised every five years guided by the World Health Organization (WHO) EML. In Nepal, the DDA does not categorize essential medicines for different levels of the health system. Instead, the respective program divisions – Primary Health Care Revitalization Division (PHCRD), Family Health Division (FHD), Child Health Division (CHD), National Centre for AIDS and Sexually transmitted disease Control (NCASC), Epidemiology and Disease Control Division (EDCD), National Tuberculosis Centre (NTC) and Logistics management Division (LMD) self-select the commodities taking into account morbidity patterns, standard treatment schedules, modification in the program, availability of resources, etc. The number and types of essential medicines and free medicines vary for different levels of health facilities.

1.4 Stock Out of Essential Medicines

Availability of medicines is one of the important measures of facility readiness and overall service quality as defined by WHO. Ensuring availability of essential medicines is also an important indicator for monitoring the results of the NHSS 2016-2021. Figure 1 shows the four-year trend on average availability of 18 tracer medicines[footnoteRef:3] across public sector facilities. In the last two years, nearly one-half of government health facilities experienced stock outs of the tracer medicines. [3: 1.Albendazole, 2. Amoxicillin tab/cap, 3. Benzoic Acid compound ointment, 4. Chloramphenicol caps/applicap, 5. Ciprofloxacin infusion/ear/ eye drop, 6. Cotrimoxazole suspension or dispersible pediatric dose tablet, 7. iron+folic acid combination tablet, 8. Gentamycin injection, 9. Metronidazole tab/syrup, 10. ORS, 11. Oxytocin injection (or other uterotonic), 12. Paracetamol tab/inj, 13. Povidone Iodine solution, 14. Salbutamol tab or inhaler, 15. Zinc Sulphate tab, 16. Isoniazid+rifampicin+Pyrazinamide (RHZ), 17. Ringer’s lactate, 18. Vitamin A.]

The Nepal Health Facility Survey of 2015 indicates that only one percent of government facilities in Nepal had all 18 tracer medicines from the EML available at the facility.[footnoteRef:4] Since data from facility-based surveys measure stock status mostly at one point in time, it does not provide a full picture of year round availability of the medicines. Hence, data from a routine information system are important. [4: Ministry of Health (MoH), New ERA, Nepal Health Sector Support Program (NHSSP), ICF. 2016. Nepal Health Facility Survey, 2015 final report]

The free health care policy of the MoH mandates district hospitals, PHCCs, and HPs to provide outpatient care and selected essential drugs free of charge to all clients/patients. Emergency and inpatient care are only available for free for selected groups: very poor/poor, destitute/helpless, elderly/senior citizens and FCHVs.

While the provision of basic health care and essential medicines is free in Nepal’s public health system, many clients return home from government facilities without medicines due to shortages in the system, potentially impacting their confidence in the health system. A comparison between the 2009 and 2012 National Household Surveys showed a 9-percentage point increase in women’s knowledge of the availability of free essential medicines at government facilities. Despite knowing that health services and medicines are free at government facilities, clients still visit private facilities/clinics to access health services and buy medicines. For instance, nearly five out of ten people who had received outpatient care in government facilities had spent money at other facilities prior to receiving care at a government facility, with more than one-third (38 percent) spending money at a private pharmacy. Similarly, nearly seven out of ten women who had received inpatient care in government facilities had spent money at other facilities prior to receiving care at a government facility. Of this, more than half (54 percent) had spent money at a pharmacy[footnoteRef:5]. The two major reasons for buying medicines outside of the public health sector were that the required medicine was not available at the facility (60 percent) and that the health facility pharmacy was closed (5 percent). [5: Mehata, S., Baral, S.C., Chand, P.B., Singh, D.R., Poudel, P., Barnett S., 2013. Nepal Household Survey 2012. Ministry of Health and Population, Government of Nepal: Kathmandu, Nepal.]

In 2009, the GoN introduced the Aama Surakshya Program, a scheme to provide financial incentives to women and health workers to give birth at a health facility with a Skilled Birth Attendant (SBA) and subsequently the user fee was removed for all types of delivery across government health facilities in Nepal. The program ensures that all women who deliver in government facilities receive maternity services, including essential medicines, free of cost.

In 2012, 70 percent of women interviewed for the National Health Facility Survey were aware of the Aama Surakshya program and 87 percent received delivery services free of charge.[footnoteRef:6] Among those who had to pay the cost for delivery services, nearly half paid for medicines because they were not available at the facility (Figure 2). [6: Mehata, S., Baral, S.C., Chand, P.B., Singh, D.R., Poudel, P., Barnett S., 2013. Nepal Household Survey 2012. Ministry of Health and Population, Government of Nepal: Kathmandu, Nepal.]

Nepal’s free drug program has faced a number of challenges over the years, including leakage into the private sector, wastage of drugs due to expiry[footnoteRef:7], and poor forecasting and quantification methodologies. The latter has often resulted in health facilities receiving levels of medicines that don’t meet the epidemiological needs of the facilities. In this context, it is important to understand the reasons why essential medicines are not always available across public sector facilities. [7: Gurung G., 2009. Free Health Care Policy in Nepal: Recent Trend and Challenges. Journal of Nepal Health Research Council 2009 Oct;7(15):138-9]

1.5 Rational Use of Medicines

According to WHO the rational use of medicines requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and at the lowest cost to them and their community. The rational use of medicines across Nepal is a pervasive issue. Common substandard medical practices during diagnosis include inadequate examination of the patient, incomplete communication between patient and doctor, lack of documented medical history, and inadequate laboratory resources. Examples of the most common irrational prescribing practices include extravagant prescribing, over-prescribing, incorrect prescribing, and under-prescribing. Common examples of irrational dispensing include incorrect interpretation of the prescription, retrieval of wrong ingredients, inaccurate counting, compounding, or pouring, inadequate labeling, unsanitary procedures, and poor packaging.

Several studies of drug utilization across many different countries, including parts of Nepal, show evidence of irrational use of medicines. A study conducted in a tertiary level hospital in Western Nepal in 2006 shows that diagnosis was mentioned in only 3.23 percent of prescriptions.[footnoteRef:8] Another study carried out in the PHCC in Kaski showed that the average number of drugs prescribed was 2.29, 57 percent were prescribed with at least one antibiotic, and 59 percent of drugs were prescribed using generic names[footnoteRef:9]. Irrational prescribing and dispensing practices could be a key factor impacting the stock out of essential medicines at health facilities. [8: Alam K1, Mishra P, Prabhu M, Shankar PR, Palaian S, Bhandari RB, Bista D, A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal] [9: Dahal, 2012]

1.6 Knowledge Gaps

There are several areas that need to be examined in-depth to understand the stock out situation and medicine use practices in Nepal. The following are some of the frequently asked questions on this topic, which can be used to guide the work of this study.

i. What factors contribute to stock out of essential medicines in the public sector?

ii. How accurate is the central level forecasting and quantification of medicines? What evidence is used for such forecasts? Is the methodology appropriate for Nepal?

iii. Are there sufficient funds available for procurement of essential medicines? How are funds managed?

iv. What role does poor management of health facilities have on stock outs?

v. What is the average time lapse between a health facility submitting a request for medicines and receipt of medicines? What are major reasons for delays?

vi. Does the health facility comply with good storage practices?

vii. Are all health workers trained on the rational use of medicines?

viii. What are the compliance rates to the standard treatment schedule?

ix. How often are clients prescribed drugs according to diagnosis and as per clinical protocols?

x. What is the average number of prescriptions per consultation?

xi. How often do clients receive the number of medicines prescribed to them according to diagnosis?

xii. Are clients advised to buy medicines from private clinics/pharmacies?

xiii. Do clients request more medicines than necessary?

xiv. Is there a tendency among clients to store medicines at home?

xv. How widespread is the expiry date problem?

xvi. What is the level of awareness among the public about the availability of free essential drugs in the public sector? Has civil society been involved as monitoring the performance of the suplly chain, specifically the frequency of stock outs?

xvii. How often does the health facility make requests for drugs - as per need, monthly quarterly?

Note to Offerors: The offerors should respond to Section 2 Technical Assistance Needed. The above questions are helpful in understanding the range of issues that need to be considered when developing the methodology.

1.7 Rationale for the Study

Various factors are responsible for the stock out of public sector medicines which range from systemic factors such as an inefficient overall procurement process, including forecasting and quantification, to human resource capacity, allocation, distribution, and transportation of medicines, poor storage practices, and irrational prescribing and dispensing practices. A systematic approach to examine these factors can help identify the root causes of stock outs and highlight areas where immediate, intermediate and long term interventions are required to improve the supply chain system, resulting in year round availability of free essential medicines across public sector health facilities.

The findings from this study will be useful to MoH, USAID and other partners in identifying the root causes that negatively impact the performance of the supply chain system to identify and implement corrective actions. The supply chain system is one of the highest priority areas identified in the Nepal Health Sector Strategy 2016-2021 and an area of great investment for the USAID/Nepal Health Office.Factors affecting the Procurement and Supply Chain System

2. TECHNICAL ASSISTANCE NEEDED

The Contractor must examine the factors that contribute to the stock out of essential commodities in the public health sector. The specific objectives of the study include:

1. Examine the factors contributing to stock out of free essential medicines at government health facilities;

2. Examine medicine prescription practices by health providers;

3. Examine medicine dispensing practices at health facilities; and

4. Assess client’s demand and use practices that may potentially contribute to stock outs.

The offerors must develop a detailed methodology to conduct a study that meets the stated objectives. The following are methodology criteria that must be addressed in the quotation:

· This study must be cross-sectional in design with both quantitative and qualitative data collection methods. The survey must nationally representative of government owned health facilities, covering 20-22 districts (250-300 health facilities of varying types). At least 2-3 districts should be selected from each province to make the estimates representative at the provincial level and by ecological zone. A subset of selected districts should be those participating in the national insurance scheme.

· The districts with higher stock out rates should be selected purposively using the LMIS data and other available information on stock outs including media. The same criteria should also be followed in selecting health facilities within the sampled districts.

Key indicators for use in the study:

i. Levels of current stocks of the 18 tracer medicines across facilities

ii. Top 5 to 8 factors contributing to stock outs of free essential medicines across facilities

iii. Percentage of facilities with expired medicines

iv. Average time to receive medicines after requisition is submitted

v. Percentage of clients that were prescribed drugs rationally at the facility

vi. Percentage of clients that received the prescribed number of drugs at the dispensary

vii. Percentage of clients who needed to buy essential free drugs from outside the public facility

viii. Percentage of clients that were advised to buy drugs from private clinics

ix. Percentage of health workers trained on rationale use of drugs

x. Percentage of clients who asked health workers to prescribe medicines that were not needed during the consultation

Note to offerors: These are a tentative list of indicators. The final indicators will be decided after this study is awarded to a contractor and the oversight team is formed. Indicators should be disaggregated by the following characteristics: type of health facility, client and provider, service type, etc.

Study methods:

Observation of client-provider interaction

· Sick child

· Maternal health

· General OPD

· History taking, assessment, diagnosis, prescription and counselling/advice

· Clients asking to prescribe specific medicines

· Use of antibiotics

Client exit interviews (sick child, maternal health, general OPD)

· Client’s satisfaction and client’s demand for medicines

· Number of medicines prescribed

· Number of essential medicines prescribed

· Number of medicines dispensed

· Number of medicines needed to buy from outside

· Total cost paid for medicine in the public facility, outside facility

· Knowledge of free health care

· Knowledge of free medicines

· Training including on the rational use of drugs

· Knowledge of the rational use of drugs

· Time required to receive medicines from higher level after putting request

· Transportation cost

· Basis for requesting stock quantity by items

· Knowledge of forecasting and quantification

· Physical count- expired medicines

· Storage practices

Program manager’s including store keepers interview DPHO, LMD, RMS, Program Divisions

· Forecasting and quantification

· Procurement

· Push and pull system- variation across districts

· Human resource capacity

· Budget sufficiency, partners support

· Procurement

· Push and pull system- variation across districts

· Human resource capacity

The Offeror can propose other methodologies to carry out a study to meet the objectives as mentioned above. The Offeror must propose the sample size and study areas with strong justifications. An oversight team will be formed at LMD for the purpose of this study. The offeror will be responsible for coordinating the oversight team, which will provide recommendations and approve the final research plan and methodology. The composition of the oversight team is provided in Section 4.

The essential medicines to be examined in this study should focus on the 18 medicines[footnoteRef:10] listed by the MOH as tracer drugs for monitoring the results of the NHSS 2016-2021. [10: 1.Albendazole, 2. Amoxycilin tab/cap, 3. Benzoic Acid compound ointment, 4. Chloromphenicol caps/applicap, 5. Ciprofloxacin infusion/ear/eye drop, 6. Cotrimoxazole suspension or dispersible pediatric dose tablet, 7. iron+folic acid combination tablet, 8. Gentamycin injection, 9. Metronidazole tab/syrup, 10. ORS, 11. Oxytocin injection (or other uterotonic), 12. Paracetamol tab/inj, 13. Povidone Iodine solution, 14. Salbutamol tab or inhaler, 15. Zinc Sulphate tab, 16. Isoniazid+rifampicin+Pyrazinamide (RHZ), 17. Ringer’s lactate, 18. Vitamin A.

3. DELIVERABLES

1. Bi-monthly updates, not exceeding three pages in writing;

2. Questionnaires in English and Nepali that have been field-tested;

3. A draft report of tentatively 20-30 pages, excluding annexes, with an executive summary targeting policy makers;

4. A draft powerpoint presentation of 20-30 slides for public dissemination;

5. A final powerpoint presentation and final report no later than 10 calendar days after receipt of USAID feedback on draft report and powerpoint.

· The final report must be clear and grammatically correct to be accepted by USAID/Nepal. The final report should abide by USAID’s branding and marking guidelines available online at http://www.usaid.gov/branding. The report format must be restricted to Microsoft products (MS Word, MS Excel, MS PowerPoint), be 12-point standard type font, and have 1” margins.

6. Once final report is approved by USAID/Nepal, the contractor will print 200 copies of the final report for distribution during the final dissemination event.

7. Final dissemination event no longer than 3 hours targeting key policy makers and program staff from MoH, DoHS, external development partners, local NGOs, and civil society;

8. Final cleaned dataset in standard format (Stata and/or SPSS);

4. PERFORMANCE PERIOD AND WORK SCHEDULE

The Contractor must facilitate and conduct thorough team planning meetings (estimated at two days, within the first two weeks of the award) before starting the study. USAID/ Nepal’s representative from the Health Office will participate in the team planning activities. MoH staff may be invited during these initial meetings as determined by the USAID Health Office.

The following are illustrative activities for the team planning meetings:

· Clarify team members’ roles and responsibilities, coordination with LMD, working styles, logistics, administration and dispute resolution;

· Develop detailed work plan

The Contractor’s work will be overseen by an oversight team formed specifically for this study. The oversight team will approve the methodology, review and endorse tools, make site visits to see data collection, review draft reports and endorse the final report. The oversight team will include the following members:

· Director, Logistics Management Division

· Senior/Public Health Administrator, LMD

· Chief, LMIS unit, LMD

· USAID Nepal representatives

· USAID’s PSM Project representative

· NHSSP/DFID representative

· UNICEF representative

· UNFPA representative

All decisions regarding the implementation of this study will be made by the oversight team.

The study is expected to be completed within six months of the signing of the contract. The suggested allocation of effort is noted below:

· Becoming thoroughly familiar with the LMD’s procurement and supply chain system

· Reviewing literature

· Develop detailed implementation plan

· Formation of oversight team

· Develop and share tools for inputs

· Coordination meetings with central level stakeholders

· Pretest and finalize tools

· Submit quotation to the Nepal Health Research Council (NHRC) for Institutional Review Board

· Obtain NHRC approval

· Recruit and train field members

· Monitoring field work and quality assurance

· Cleaning and processing of data

· Synthesizing data and generating draft tables

· Share reports with the study oversight team and other stakeholders as advised by the team

· Carryout further verification, if and as needed

· Finalize report and submit to USAID

· Share findings at national level through the dissemination event

The effective date of this Purchase Order is the approval date of the Executive Office. The period of performance includes some flexibility for unforeseen circumstances such as weather and strikes. It also includes non-working days.

5. LOGISTICS

The contractor is responsible for arranging all of the logistics including, but not limited to: communications, stationery/document management and reproduction, computer, administrative/secretarial work, meeting/interview schedules, meeting refreshment costs, report printing costs, transportation in Kathmandu and field visits, per-diems and travel cost for government personnel joining field trips and group personal accident insurance coverage. Anything budgeted to accomplish this work is reflected in the total cost of the Purchase Order.

6. CONTRACTOR REGISTRATION

All prospective U.S. Government contractors are required to obtain a DUNS number and to complete the System for Award Management (SAM) registration before a contract may be awarded. To learn more and to begin the registration process, please visit the following websites:

DUNS number: http://fedgov.dnb.com/webform

SAM registration: http://www.sam.gov

Quotation may be submitted under this RFQ without a DUNS number or SAM registration. However, the successful awardee will be required to obtain both of them and submit evidence of registration to USAID before an award is made. The registration process may take many weeks to complete. Therefore, Offerors are encouraged to obtain them early so that, if selected, the award will not be delayed.

As authorized under Section 7077 of Public Law 112-74, the Consolidated Appropriations Act, 2012 (P.L. 112-74), “Local Competition Authority,” USAID/Nepal limits this competition to local entities.

Local entity means an individual, a corporation, a nonprofit organization, or another body of persons that:

1) Is legally organized under the laws of Nepal;

2) Has as its principal place of business or operations in Nepal; and

3) Either is:

a. Majority owned by individuals who are citizens or lawful permanent residents of Nepal; or

b. Managed by a governing body the majority of whom are citizens or lawful permanent residents of Nepal.

"Majority owned" and "managed by" include, without limitation, beneficiary interests and the power, either directly or indirectly, whether exercised or exerciser, to control the election, appointment, or tenure of the organization's managers or a majority of the organization's governing body by any means. Additionally, at least 50 percent of the cost of contract performance incurred for personnel must be expended for employees of the prime/local entity.

By submission of an offer and execution of a contract, applicants represent that they are local entities and agree to the limitation on subcontracting above. Applications from entities who do not meet this definition will not be included in the competition.

7. QUOTATION SUBMISSION INSTRUCTIONS

Quotation length not to exceed ten pages, with additional pages for budget, curriculum vitae of key personnel involved in the process in MS Word/Excel/PowerPoint format.

The quotation should include following:

· Background

· Detailed methodology

· Detailed activities and work plan

· Budget (in Excel sheet) with details of personnel cost, travel cost, secretarial cost, miscellaneous cost, institutional overhead (if applicable).

· CVs of team leader and other key members

· Institutional profile and contact details of 2 references for each team member (2 pages max each)

The Contractor will be selected through a competitive solicitation process. The team must consist of a local firm or a group of local consultants, including one team leader as a point of contact to communicate with USAID. In ensemble the team members must meet the following criteria:

· Strong team skills

· Ability to work with persons of diverse professional and social backgrounds with varying opinions

· Strong written and verbal communication skills in English and Nepali

· Demonstrated strong technical and analytical skills focusing on procurement and supply chain system strengthening

· Ability to travel and work for short durations in challenging environments

Team Leader The team leader must be a local senior level professional with at least ten years of experience, preferably involved in similar assignments. The team leader must have a Master’s in Public Health, medicine, public administration, health sciences, pharmacy or equivalent. S/he must have successful experience showing competency to supervise other local experts and produce a high quality report. Particular expertise and experience should include:

- Strong research and analytical skills

- Strong knowledge of procurement and supply chain system

- Prior experience as the team leader of similar assignment

- Strong team management and supervisory skills

- Demonstrated lead writer with strong technical English writing skills

- Experience working with a range of government officials, donors, local NGOs, academia

Procurement and Supply Chain Expert The Procurement and Supply Chain expert must have at least a Master’s degree in medicine, nursing, pharmacy or public health, or equivalent with general health background. He/she should have at least five years of experience, preferably on similar assignment. This expert must work under the supervision of the team leader and will be responsible for supporting the team leader in design and methodology, coordination with LMD and partners, training, data analysis and report writing.

The team leader or the associated firm must recruit additional short term statistician, data processor, data entry person, logistics support person and field researchers to carry out data collection at districts. The field researcher must have pharmacy, general health, auxiliary health, or nursing background. The number and type of persons should be budgeted and justified in budget quotation. USAID expects the Contractor to involve appropriate MoH staff in design, field/monitoring, analysis, reporting and dissemination of the findings and allowable cost (per/diem during field trips, travel cost) should be budgeted and justified in the budget quotation. Quotations should identify number, name and qualification and contact details of these team members, but not necessarily include CVs of these individuals.

We anticipate start of this assignment by December 15, 2017 and completion by May 2018. However, based on the SOW, Offerors may propose their own LOE estimate to complete the work.

The Offerors must submit the quotation by November 20, 2017 either

a) Electronically – internet email with attachments compatible with Microsoft Word, Excel (max 5 MB in each email) to: kathmanduOAA@usaid.gov with “ Factors Contributing to Stock Out of Essential Medicines in Government of Nepal Health Facilities” in the subject line

b) Via regular mail or hand delivery - sending one original and one copy of hard/paper copies of a technical and cost quotation and electronic copies in CD-ROM in MS Word, MS Excel to:

Executive Office US Agency for International Development, Nepal Maharajgunj, Kathmandu, Nepal Please mark the envelope with “Factors Contributing to Stock Out of Essential Medicines in Government Health Facilities of Nepal Quotation”

9. COST QUOTATION

The Offeror must submit a proposed budget in US dollars in MS Excel format using the attached template in Table 1, along with a budget narrative explaining all proposed expenses.

Under the bilateral agreement between USAID/Nepal and the GON, development assistance programmatic funds are exempt from taxes to the GON. As such, USAID/Nepal does not finance any identifiable host country taxes.

Table 1: Budget template Budget and Justification (Do not exceed two pages)

a. Personnel costs

b. Travel and per-diem Air-fare Per-diem Ground transportation (airport tax, local taxi etc)

c. Other Direct Cost Communication Printing/Copying Dissemination NHRC fee Other (Specify …………..)

f. Fee/profit (if applicable)

Total cost (cost+fee)

TOTAL

Instructions for preparing the Cost Quotation

The Cost Quotation must be separate from the Technical Quotation and must reflect realism, completeness, and reasonableness. Offerors shall submit a budget in format provided in Table 2 with a narrative providing detailed justification of costs anticipated under this proposed Purchase Order.

10. TECHNICAL INSTRUCTIONS TO OFFERORS

Following reference materials are recommended for literature review:

· Nepal Health Sector Strategy 2015-2020, Ministry of Health of Nepal.www.mohp.gov.np

· National Drug Policy 1995, Ministry of Health and Population, Kathmandu. Available at www.dda.gov.np

· Facility Based Assessment for Reproductive Health Commodities and Services, NDRI, UNFPA, May 2014

· Promoting rational prescribing - World Health Organization,

· Nepal Household Survey 2012. Ministry of Health and Population, Government of Nepal: Kathmandu, Nepal (Mehata, S., Baral, S.C., Chand, P.B., Singh, D.R., Poudel, P., Barnett S., 2013).

· RTI International (April 2010): Pro-Poor Health Care Policy Monitoring: Household Survey Report from 13 Districts. Research Triangle Park, NC, USA.

· Ministry of Health (MoH), New ERA, Nepal Health Sector Support Program (NHSSP), ICF. 2016. Nepal Health Facility Survey, 2015 final report

11. EVALUATION CRITERIA

The criteria presented below have been tailored to the requirements of this particular Purchase Order. To facilitate the review of quotations, Offerors should organize the narrative sections of their quotations in the same order as the selection criteria. The quotations will be evaluated in accordance with the Technical Evaluation Criteria set forth below. Thereafter, the cost application of all Offerors submitting a technically acceptable application will be opened and costs will be evaluated for reasonableness and fairness for the work required and offered.

Technical and cost factors will be evaluated as described herein.

(a) The technical quotation will be scored by a Technical Evaluation Committee using the criteria described in this Section.

(b) The cost quotation will be scored by the method described in this Section.

(c) The criteria below are presented by major category, with relative order of importance. The criteria below reflect the requirements of this particular solicitation.

A. Study Team Composition (30 points)

· Demonstrated ability of the Team Leader and the Expert to write and communicate findings (10 points)

· Academic qualifications for proposed Team Lead and the expert (5 points)

· Mix of skills between Team Lead and the experts (10 points)

· Overall composition of the Study team (5 points)

B. Technical Approach (50 Points)

· The degree to which the quotation demonstrates a clear understanding of the problem statement (10 points).

· Detailed and strong methodology developed to measure the study objectives (20 points).

· Sample size with statistical power explained

· Selection of districts with justification

· Data collection methods

· Prepare a realistic work plan and time table (10 points).

C. Past Performance (20 points)

· Similar assignment accomplished previously (20 points).

Non-Disclosure Agreement PRECLUSION FROM FURNISHING CERTAIN SERVICES AND RESTRICTION ON USE OF INFORMATION With respect to quotation submitted dated ____________ in response to solicitation to purchase service of local research firm dated _______________ for completing study on factors contributing to stock out of essential medicines in Nepal, the undersigned hereby agrees and certifies to the following:

(a) This SOW calls for the Contractors to furnish important services in support of study on factors contributing to stock out of essential medicines in Nepal. In accordance with the principles of FAR Subpart 9.5 and USAID policy, the Contractor shall be ineligible to furnish, as a prime or subcontractor or otherwise, implementation services under any contract or task order that results in response to findings, quotations, or recommendations in the evaluation reports within 18 months of USAID accepting the reports, unless the head of the contracting activity, in consultation with USAID’s competition advocate, authorizes a waiver (in accordance FAR 9.503) determining that preclusion of the Contractor from the implementation work would not be in the Government's interest.

(b) In addition, by accepting this contract, the Contractor agrees that it will not use or make available any information obtained about another organization under the contract in the preparation of quotations or other documents in response to any solicitation for a contract or task order.

(c) If the Contractor gains access to proprietary information of any other company in performing this evaluations, the Contractor must agree with the other company to protect the information from unauthorized use or disclosure for as long as it remains proprietary, and must refrain from using the information for any purpose other than that for which it was furnished. Contractor must provide a properly executed copy of all such agreements to the contracting officer.

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