TERMS OF REFERENCE
FOR CONSULTANCY SERVICES FOR
“Designing PRIME health service initiative”

1. BACKGROUND

Bangladesh has made impressive progress in poverty reduction on a global level. However, progress has been slower in some areas, especially the north-western region of the country. The region is lagging behind many others in development and available economic opportunities. In the greater Rangpur region incidence of poverty remain unusually high and chronic food shortage and hunger remain an enduring phenomenon of rural life.

According to Household Income and Expenditure Survey 2005 (HIES), of Bangladesh Bureau of Statistics (BBS), the poverty head count rate for the entire country was 40% while in the greater Rangpur region (Rangpur, Gaibandha, Nilphamari, Kurigram and Lalmonirhat) poverty rate was 57%. Similarly, extreme poverty rate was 25% nationally, compared to 43% in the greater Rangpur region. Moreover, this region experiences seasonal deprivation and famine-like situations, locally called “monga” during mid-September to mid-November corresponding to post planting and pre-harvesting of major Amon rice crop. Another such period is mid-March to mid-May corresponding to post-Rabi and pre-Boro harvesting in this region. Households primarily reliant on agricultural wages find their pre-harvest purchasing power dropping drastically due to a rise in staple food prices coupled with a fall in local labour demand and wages.
PKSF with its experience in tackling situations of severe poverty through its various programmes had launched PRIME in August 2006 to eradicate monga permanently. In the first year, the project covered all the five upazilas of Lalmonirhat district. In 2007, with funding from DFID under PROSPER Programme, PKSF extended the coverage of PRIME to the other four districts (Nilphamari, Kurigam, Gaibandha, Rangpur) of greater Rangpur region. Till June 2009, the project has covered 35 upazilas of five districts through 235 branches of 16 partner NGOs.
The objective of PRIME is to prevent the consequence of monga by generating income through wage employment and self-employment opportunities for the monga-affected people throughour the year. PRIME implements number of interventions among the monga affected households. The interventions include Cash for Work (CFW), Emergency Loan, Flexible Microcredit, skill development training and other essential support services (i.e. health).
Health services are widely needed in the region. Therefore, PRIME intends to undertake health service activities among the monga affected people to ensure better livelihood support in addition to credit programme. Initial identification of some specific needs of health services have been done but to effectively implement the services, PRIME requires assistance from primary health specialist in designing its health service component. Specialist individuals/organizations can provide necessary insights to strengthen the proposal.

2. OBJECTIVE OF THE INITIATIVE

To increase awareness on health, hygiene and nutrition and ensure improved access in health services amongst the poorest communities, especially focusing on women and children.

3. SCOPE OF WORK

i) Design and develop a document on PRIME health service initiative, delineating the scope and objectives, and its implementation modality, matching with PKSF’s focus and the needs of the area.
ii) Assess training needs for the Health Assistants, develop training module and arrange required training materials.
In undertaking this activity, the consultant/organisation needs to consider, but not limited to, the following services:
· Maternal & Child health awareness
· Reproductive health awareness
· Awareness on Communicable Disease Control
· Behaviour Change Communication
· Awareness on nutrition and hygiene
· Awareness on safe water and sanitation
· Ensure strong referral system (GOB, NGO and private facilities)

4. DELIVERABLES

Complete project document with implementation strategies and HR requirements.

5. TIMELINE

The work is to be completed in six weeks, including submission of final document.

6. ELIGIBILITY OF INDIVIDUAL CONSULTANT/ORGANISATION

Must have:

· Proven experience of designing national level primary health project/s
· Proven experience of implementing primary health care project/s
· Proven experience of training need assessment and module development related to primary health

Desirable:

· Working experience with poorest community group
· Experience in northern part of the country
· Good understanding of GOB health system