Zim-TTECH
DUE: 15 OCT 2024
Date: 03 September 2024
Title: Terms of Reference: Consultancy services to conduct an evaluation of the Impilo Electronic Health Records (EHR) system in Zimbabwe.
Location: The duty station is Harare, Zimbabwe. However, the consultant maybe required to travel to health facilities in other provinces.
Timeframes: Anticipated dates: Start date 01 October 2024; end date 28 February 2025, duration 30 working days
Purpose of this consultancy
The objective of this consultancy is to engage a qualified consultant to conduct an evaluation on the implementation of the Impilo EHR system.
Background
In 2016, the Ministry of Health and Child Care (MoHCC), with the support of its stakeholders, came up with a comprehensive, patient-centric integrated national EHR solution called Impilo (meaning ‘life’ in the local language of IsiNdebele or ‘health’ in IsiZulu). Impilo was designed and developed by a 100% Zimbabwean technical team under the MoHCC with the support of its partners. In the Zimbabwean and the MoHCC context, Impilo describes an ecosystem of interoperable or integrated solutions/applications that communicate through a health information exchange framework. Within that framework or ecosystem is a point of care solution called Impilo EHR. The Impilo EHR system assists the MoHCC and its stakeholders at the national, provincial, district and health care facility levels to collect key strategic information (SI) required to measure progress towards achieving epidemic control and generate a strong evidence base for informed program decision-making in Zimbabwe. Since then, several changes in the program have been made including major modifications to the system’s features, provision of site technical and clinical support, and institution of new partners to assist in the system implementation.
Purpose of the evaluation
The process evaluation key objectives are as follows:
- To understand stakeholder perceptions of Impilo EHR
- To describe the processes used to develop, deploy, implement, and support Impilo EHR
- To describe key factors impacting Impilo EHR system development, deployment, and implementation/use and achievement of project goals
The questions guiding the evaluation are as follows:
- To what extent has the Impilo EHR software been developed, deployed, and supported as intended?
- To what degree are the resources (material and human) used to support Impilo implementation adequate?
- What are the levels of Impilo system use, acceptance, adoption, and satisfaction among system users?
- What is the level of Impilo EHR availability, accessibility, and coverage?
- What internal and external factors are impacting EHR system strategic planning, development, deployment, implementation/use, and achievement of project goals?
Methodology for the evaluation
The process evaluation will involve quantitative and qualitative methods to assess the implementation of the Impilo EHR project and to make actionable recommendations. The Impilo EHR process evaluation will be carried out through participation of relevant stakeholders including MoHCC, implementing partners, and health facility staff. Field visits for data collection are envisioned. Data collected should be disaggregated (by sex, age, and location), where possible. Data will be mainly collected from various information sources through:
- a comprehensive desk review and analysis of relevant documents, reports, information, data/statistics, etc.;
- stakeholders’ key informant interviews;
- survey.
Scope of Work
The consultant will provide evaluation services in assessing the implementation of Impilo EHR to understand the potential impact on use for service delivery. The consultant will be tasked with the following activities:
- Conduct a comprehensive desk review of documents describing the Impilo EHR implementation processes and components. These will include documents that describe the software development and deployment processes; resources supporting project implementation; stakeholders’ perceptions about data accessibility and availability as well as levels of acceptance, adoption, satisfaction, and sustained use among users.
- Engage with key stakeholders, including healthcare providers to gather feedback on the above highlighted issues above through a survey and key informant interviews (anticipated sample: KIIs – 20, survey – 400)
- Analyse data from the survey and interviews. Consultant is expected to have appropriate quantitative and qualitative data analysis software.
- Present the findings and actionable recommendations to MoHCC and relevant stakeholders and incorporate feedback into the final report.
- Prepare and submit the final narrative report and presentation.
Deliverables and timeframes
Below are the deliverables expected from this consultancy work:
- Inception report: The consultant will prepare an inception report, which details the consultant’s understanding of the evaluation and how the evaluation questions will be addressed. This is to ensure that evaluator and key stakeholders (MoHCC, Zimbabwe Technical Assistance Training & Education Center for Health (Zim-TTECH), and the U.S. Centers for Disease Control and Prevention) have a shared understanding of the evaluation. The inception report will include the evaluation matrix summarizing the evaluation design, evaluation questions, and methodology including data sources and the associated collection and analysis methods and tools, and the measures, evaluation criteria, or indicators by which each question will be evaluated. The report will also include the scope of work, work plan, and timeframe. The report is expected within 5 days after starting the evaluation process. The inception report should include a proposed schedule of tasks and activities and deliverables with clear responsibilities for each task or product. The inception report will be discussed and agreed upon with all key stakeholders.
- Draft evaluation report: The consultant will prepare a draft Impilo EHR Evaluation Report (full MS Word narrative report and MS PowerPoint slide deck) and submit to MoHCC for review and comments within two weeks of data collection completion. MoHCC will distribute it to its stakeholders for review and comments. Feedback from the stakeholders will be provided within 15 working days after the reception of the draft report. The report will be reviewed to ensure that the evaluation meets the required quality criteria. The report will be produced in English. MoHCC will be responsible for ensuring timely arrangement for a stakeholder meeting for the review and validation of the evaluation report.
- The final narrative report (approximately 30 to 40 pages excluding appendices): This will be submitted within 10 working days after a stakeholders’ meeting to present the evaluation findings and will include addressed comments from the program stakeholders. The content and the structure of the final analytical report with findings and actionable recommendations covering the scope of the evaluation should include the following:
- Executive summary (1-2 pages): Contains evaluation purpose, evaluation questions, brief description of project being evaluated, data collection methods, analytic methods, evaluation findings, limitations, and recommendations /conclusions.
- Introduction and evaluative literature review (4-5 pages)
- Project Background: Brief description of program/project to be evaluated including dates of project implementation, total cost, geographical location, and objectives (3-4 pages)
- Description of the evaluation design, methods, and limitations:
- Overall evaluation design (specifying evaluation type, sampling strategy, data collection methods and rationale, data handling procedure, data analysis plan, evaluation limitations etc) (4 pages)
- Summary of stakeholder engagement (0.5 pages)
- Ethical considerations and assurances (e.g., non- research determination and/or IRB approval with dates; application of informed consent, if appropriate; procedures to ensure protection of human subjects) (1 page)
- Deviations and adjustments (if any) from the approved Scope of Work and/or protocol (0.5 page)
- Evaluation key findings (15-20 pages): key and unexpected findings for program improvement in relation to evaluation questions
- Conclusion and actionable recommendations (4-5 pages): Actionable, feasible, and specific recommendations aligned to key findings
- Dissemination (0.5 page): Description of dissemination procedures/plan
- References: List of reports or publications cited in the report
- Appendices:
- Approved evaluation Scope of Work and/or protocol
- Terms of reference
- Data collection instruments/tools
- Documents reviewed
- Informed Consent
- Abridged bios of the evaluation team members including qualifications, experience, role on the team, and ethical certifications
- Conflict of interest statement
- Evaluation costs
- Project results framework or logical framework
- The final PowerPoint slide deck (max 30 slides) with key sections/points from the narrative report
Timeframe for the evaluation process
The evaluation will be conducted between October 2024 and February 2025 for an estimated 30 working days. The consultant will be provided with information to prepare a table with tasks, timelines, and deliverables, for which the consultants will be responsible and accountable, as well as those involving the commissioning office (MoHCC, Zim-TTECH) indicating for each, who is responsible for its completion.
Management; organisation and timeframe
The selected consultant will report to MoHCC. The evaluation will be managed by Zim-TTECH on behalf of MoHCC with a review panel made up of representatives from implementing agencies.
Qualifications and expertise required
The consultant must have the following expertise and qualifications:
- At least a master’s degree in programme monitoring and evaluation or a related field
- Extensive expertise, knowledge, and experience in the field of evaluation of information systems in health programmes
- Experience working with health information systems / electronic health records systems.
- Experience supporting programme monitoring and evaluation activities
- Familiarity with health information systems
- A track record and traceable reference of excellent quantitative and qualitative data collection, analysis, and report writing. Samples from previous work will be required.
- Excellent written and verbal communication skills in English.
Application process
If you are an organization or individual, who is interested and is available during the timeframe, please submit your proposal package. The proposal package should be submitted by e-mail to: [email protected] c/o Procurement Committee or as physical copies to the attention of the Procurement Committee Chairperson at 10 Natal Road, Belgravia, Harare, by the closing date and time stated. This request for proposals does not obligate MoHCC/Zim-TTECH to award a contract, nor does it commit MoHCC/Zim-TTECH to pay any costs incurred in the preparation and submission of the proposal.
Documents to submit
- Letter of confirmation of interest and availability including a brief description of why the individual/team considers him/herself/themself as the most suitable for the assignment.
- Personal CVs of the lead evaluator and team members indicating all past relevant experience from similar projects as well as contact details (email and telephone number) and at least three (3) professional references.
- Technical proposal including a methodology on how he/she/they will approach and complete the assignment (max 6 pages).
- Financial proposal that indicates the all-inclusive fixed total contract price, supported by a breakdown of costs. The financial proposal must be submitted as a separate attachment.
- At least one (1) past evaluation report from similar evaluations.
Delivery instructions
Tender identification: All correspondence regarding this tender must be marked with the following inscription:
Request for proposals (RFP) for consultancy services to conduct a process evaluation of the Impilo Electronic Health Records (EHR) system at selected health facilities in Zimbabwe.
Selection criteria
Submissions will be evaluated in consideration of the evaluation criteria as stated below:
| Criteria | Weight | Max. Point |
| Qualifications of the Lead Consultant – at least a master’s degree in Programme Monitoring and Evaluation | 10% | 10 |
| The team’s qualifications | 5% | 5 |
| Extensive expertise, knowledge, and experience in the field of information systems in health programmes | 5% | 5 |
| Experience of programme evaluation | 5% | 5 |
| Experience health information systems programming or evaluation | 5% | 5 |
| A track record and traceable reference of excellent quantitative and qualitative data analysis and report writing. | 10% | 10 |
| Samples from previous work | 10% | 10 |
| Overall quality of the technical proposal | 35% | 35 |
| Financial proposal | 15% | 15 |
| TOTAL | 100% | 100 |
Applications should be submitted by 15 October 2024. Shortlisted candidates will be contacted for an interview.
Remuneration
The consultant will be compensated at a competitive rate commensurate with qualifications and experience. The consultant shall be paid the consultancy fee upon completion of the following milestones:
- 25% after adoption of the inception report
- 25% after presentation of the draft report
- 50% after the approval of the final report
The consultancy fee will be paid as lump sum amount (all-inclusive of expenses related to the consultancy). The contract price will be fixed regardless of changes in the cost components.
Note: The successful consultant must avail a valid ITF 263 (Tax Clearance Certificate) at the time of settling the Invoice. In the event of failure to produce a valid ITF 263, Zim-TTECH will withhold 30% which will be remitted to the Tax Authority (ZIMRA) and the consultant issued with a tax withholding certificate.
We are committed to achieving workforce diversity in terms of gender, nationality, culture, and educational background. Individuals from minority groups are encouraged to apply.