To assess the effectiveness of the USAID TB Control Program activities related to community involvement in the detection and treatment of TB in the pilot areas of the program and develop recommendations for further improvement and expansion.
The USAID TB Control Program (USAID TBCP) is a five-year Program implemented by Project HOPE in two countries of Central Asia – Tajikistan and Uzbekistan. The purpose of the Program is to ensure more effective and more accessible tuberculosis (TB) diagnosis and treatment for all, including vulnerable populations, so as to reduce the burden of TB and the development of drug-resistant TB in Central Asia.
The Republic of Tajikistan is one of the18 high-priority countries for multidrug-resistant TB (MDR-TB) in the World Health Organization (WHO) European Region. TB is more prevalence among male population, affecting mostly the young population 15-24 years and the population in the most productive age group 25-34 years in both gender groups.
The country is becoming increasingly successful in the implementation of National TB program. MDR treatment coverage among diagnosed patients is increasing every year and a significant number of national and international non-governmental organizations, communities and other partners are involved in supporting tuberculosis prevention and control activities in the country. Despite the progress made, Tajikistan still faces many challenges in tuberculosis control especially with early TB case detection and low treatment success rate among MDR/XDR TB patients. The National TB Program (NTP) is heavily dependent on international donors, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and USAID, and country current funding is insufficient to fully scale-up DR TB prevention, diagnostic and control activities. Patient-centered approaches and social support services for patients exist only on a very limited scale and lack standardization.
To address the gaps associated with low TB case detection and low treatment success rate, the Program, along with activities aimed at strengthening the capacity of NTPs to provide quality services for TB diagnosis and treatment, designed and implemented activities related to community engagement targeting vulnerable population. The Program activities include establishment of Community Health Committees (CHCs) to improve access of population to TB diagnostics and treatment, involvement of local NGOs to work with most vulnerable population (PLHIV, PWID, prisoners/ex-prisoners, migrants), establishment of the Patient’s Schools and Patients Support Groups to provide treatment adherence support to TB patients in Program pilot sites.
C. Objective(s) and those link to Program
The main objective of this assignment is to Conduct operational research to assess the effectiveness of the USAID TB Control Program activities related to community involvement in the detection and treatment of TB in the pilot areas of the program, and develop recommendations for further improvement and expansion.
The assignment will contribute to the Objective 1, activity 1.4.4 “Conduct operational research (OR) with involving international experts/universities in effective community engagement in TB control” of the Program’s approved work-plan for Year 4.
The following tasks will be implemented:
- Develop methodology to conduct operational research on community engagement on TB;
- Design research protocol and agree with Programm team;
- Conduct the research in selected districts of the country;
- Present the results of research at country level;
- Prepare and submit a detailed report on the research.
The following will be delivered upon completion of the assignment:
- Report on research;
- Presentation of research results at national level.
The consultant will report to USAID TB Control Program Country Director Tajikistan.
This SoW can be amended by USAID TB Control Program Country Director, in consultation with Regional Community Engagement Advisor and Regional Technical Director.
G. Level of Effort, Timeline and Itinerary
The total proposed level of effort for this assignment is 45 days. The assignment is planned from August 2018 till September 2018. Preliminary schedule of the assignment is:
· Day 1-3: desk review of available community engagement documentations;
· Day 4: arrival to Dushanbe, meeting USAID TB Control Program;
· Day 5-9: meeting with National TB Program (NTP), National Center for Healthy Lifestyle (CHLS), national and international stakeholders, CSOs;
· Day 10-18: site visits to the regions;
· Day 19-28: drafting research report;
· Day 29: presentation of preliminary results to USAID TBCP and stakeholders;
· Day 30: departure from Dushanbe;
· Day 31-45: completion of the research report, addressing comments provided, development and submission of mission report to USAID TB Control Program.
H. Required Skills and Experience
-Master/University degree in health, public health, social sciences, communications
-Minimum five years of experience in designing and conducting researches on community engagement in health issues;
-Good knowledge of community engagement, behavior change communication, social mobilization in tuberculosis;
-Excellent analytical and report writing skills;
-Ability and willingness to travel internationally and locally;
-Able to work efficiently and promptly with team members and stakeholders;
-Fluency in English, good knowledge of Russian or Tajik is an asset;
-Excellent computer skills, including WS office and statistical software.