Purpose of consultancy
The private sector plays a critical role in family planning (FP) and can contribute to a total market approach to providing contraceptives. Information on current sources of modern contraceptive methods is critical for planning and programme implementation. The latest Pakistan Demographic & Health Survey 2017-18 captured the source of modern contraceptive methods (all methods) in AJK and GB. Government hospitals have the highest share in both AJK and GB (around 32%). The share of the private sector in GB was highest (even from the national average) around 48%. Whereas about around 30% of the total modern contraception methods were availed from the private sector in AJK.
Under the ambit of Council of Common Interests, Govt. of Pakistan (CCIs) recommendation, it is proposed that to conduct the mapping of all general registered private practitioners (including those working private hospitals and/or clinics) to provide FP counselling, information, and services to male & female clients in the provinces and ICT including AJK and GB. Population Welfare Departments in the respective provinces are now responsible to conduct such mapping. However, it was learned that the Ministry of National Health Services, Regulations and Coordination has already initiated the mapping of all public and private health services providers covering all health-related services including family planning in ICT. However, the final report is not yet available. To avoid the duplication of the efforts, UNFPA intends to focus on the two largest districts of AJK (Muzaffarabad) and GB (Gilgit).
This special report presents a case study of a promising model for increasing contraceptive availability in two largest districts of AJK and GB, which could subsequently be replicated in other large cities in Pakistan and elsewhere in the country.
Although the coverage is limited to the two districts, the three follow-up actions would be intended: 1) a state-of-the-art mapping of all family planning sites on an interactive GIS mapping, to assess coverage and identify underserved areas throughout the city; 2) the creation of a Family Planning Coalition. The coalition is proposed to consist of the organizations involved in family planning service delivery in selected cities along with representation from international donor agencies. The coalition is to be formed based on enlisting and signing Letter of Understanding (LOU) with the private providers/coalition and PWD; and 3) heightened interest of international donors in investing in family planning in AJK and GB because this evidence base will be available to guide such work.
Scope of work:
Increasing contraceptive prevalence requires an adequate supply of services, including service provision, contraceptive commodities, and information on the one hand, and an adequate demand for those services, on the other hand. The latest round of PDHS empirically has shown that the private sector has a significant share in the family planning services. Thus, an important first step was to assess the supply side by identifying all health facilities and pharmacies in AJK and GB that offer at least one contraceptive method, and which provide detailed information on the number and geographic location of sites, as well as their key attributes (e.g., type of contraceptives available, number of staff with family planning training).
1) The purpose is to conduct a mapping exercise that enumerates the types of services and geographic location of all public- private health facilities and major pharmacies in the two largest districts of AJK (Muzaffarabad) and Gilgit-Baltistan (Gilgit) that provide the family planning counseling, information, services, referrals, and contraceptive methods or distributed them free of charge. We also intend to include LHWs/LHVs, private/NGOs hospitals, private doctors, and health facilities in the mapping exercise.
2) Identify the bottlenecks and out interventions to enhance the role of private sector in delivering the family planning services.
The fieldwork will be divided into two-phase. In the first phase, the consultant with the help of the enumerators will do a listing of all public and private health facilities and other private outlets along with the geographical coordinates, and develop a list of the facilities and private outlets and draw it on the map of the respective district. In the second phase, Interviewers will visit each site and will administer a short questionnaire to the person who is responsible for family planning services, to collect specific information about the site: type of facility (e.g., hospital, clinic), ownership (e.g., public/private), delivery of family planning services, volume of each contraceptive method in stock, number of staff members trained in family planning in the past three years, availability of an information system to track the quantity of contraceptives sold or distributed free of charge and quantities of methods sold or distributed.
On the basis of the data, we will create a quality rating system for sites that awarded one star each for having at least three modern contraceptives in stock, at least one staff member trained in family planning in the past three years and an information system that tracks the number of contraceptives distributed. Thus, sites that met all the criteria will be rated as “three-star sites.
The assignment will consist of the following key tasks:
· An overview of the types of health services and products offered by the private sector with a particular focus on family planning (FP) and maternal and child health (MCH);
· To collect a complete list of private hospitals, health facilities, and LHWs along with geo-location;
· To collect information about health facilities regarding an essential human resource, availability of services like Lab, MNCH and Family Planning;
· To Develop GIS Layered Dashboard presents all health facilities marked on Map with Layers;
· Show complete information collected along with pictures of health facilities and health houses.
· Strategic priorities of policies, market conditions and business needs that inhibit or enable private sector participation in the health system.
· Prepare a summary of the mapping study highlighting the key findings, recommendations, and policy options.
· Support in presenting the findings of the reports/summary report in an expert meeting that will be called for validation;
· Support in finalizing the reports integrating the outcome of the validation meeting and comments from experts;
Duration and working schedule:
The assignment should be completed in 45 working days before 30th November, 2019 from the date of signing the contract.
The consultancy assignment will be completed in the following stages. Keeping in view the nature of the assignment, a team of two consultants would be recommended. One consultant would serve as the lead researcher and other should have sufficient experience in data entry and analysis, and GIS mapping skills.
- Home-based: initial desk review and developing the study design including questionnaire:
- Presenting the study design to the TAG, HPSIU, and UNFPA team
- On-site work: Data collection in the two districts
- Home-based: Draft report and recommendations
- Validation meeting:
- Final report, and summary
Place where services are to be delivered:
The consultant will work remotely and will have close coordination with MoNHS, R&C (HISPU) and UNFPA.
Muzaffarabad (AJK) and Gilgit (Gilgit Baltistan)
The consultant will simultaneously report to the Director, Health Planning System Strengthening & Information Analysis Unit (HPSIU), Mo NHSR&C and International Family Planning Advisor UNFPA. He/She also work jointly with UNFPA team and coordinate relevant technical support from TAG members.
Required expertise, qualifications and competencies, including language requirements:
- Master’s degree or higher in Public Health, and Statistics or a relevant combination of education.
- Minimum 7 years of professional experience in the field of sexual and reproductive health, family planning and research.
- Knowledge of Pakistan’s FP landscape, population dynamics, and socio-cultural issues.
- Proven ability to design survey/census operation with strong research skills in primary data collection and analysis.
- Experience in GIS mapping and use of GIS software’s (e.g. Arc GIS).
- Proven ability to work effectively with government officials.
- Languages: Fluency in oral and written English;
- Excellent interpersonal and general communication skills.