CALL FOR PROPOSALS Technical Assistance for the Conduct of Baseline Study for the Subnational Initiative Project, Phase 2 1. Summary The World Health Organization (WHO) Philippines is looking for an institutional contractual partner as a Technical Assistance provider for the Conduct of Baseline Study for the Subnational Initiative Project, Phase 2. The proposals are due by 05 September 2020. 2. Background The Subnational Initiative (SNI) Project Phase 2 builds on the achievements/ successes of the Korea International Cooperation Agency (KOICA) funded “Accelerating Convergence Efforts through Systems Strengthening for Maternal and Newborn Health” (ACCESS for MNH) project (henceforth called Phase 1 project) that was implemented in the Davao Region of the country from 2015 to 2018. Phase 1 of the project has already demonstrated the importance and effectiveness of its innovative systems approach1 in developing the then service delivery network (SDN) which is now enhanced into the health care provider network (HCPN) for maternal and newborn health (MNH) that is responsive to the needs of the community and is also accountable to them. With several key effective strategies being adopted at the regional level, the project has shown that it has the potential to influence the way that HCPNs are developed for MNH in the whole country. It has also shown that there is potential for the project effective strategies to be relevant not just for delivery of MNH services but for the larger health care agenda. Given that the Philippine Development Plan (2017-2022) emphasizes the importance of improving the responsiveness of the health system, and that the National Objectives of Health’s(NOH) 2017-2022 three major goals aspires for: (1) better health outcomes with no major disparity among population groups; (2) financial risk protection for all especially the poor, marginalized and vulnerable; and (3) responsive health system which makes Filipinos feel respected, valued and empowered, there is a need to take these effective strategies to the national level so as to complement, and render more effective, the good work that DOH is doing on Health Care Provider Network (HCPN) development. The proposed project will hence focus on effective strategies to develop effective health care providers network (HCPNs) with transparent community linkages that can deliver Universal Health Care (UHC) as stipulated in the UHC Law. It will capitalize on the learnings of SNI Project Phase 1; build on HCPN approaches being tried elsewhere in the country by the government as well as other non-government agencies; and work with the community and Local Government Units (LGUs) to ensure the setup of a responsive HCPN. This will be done through a two-pronged approach that concentrates on: a) Application of the effective strategies* on the systems approach innovated in Phase 1 from its focus on MNH to primary health care (PHC). This will be done through intensified support to government units, both municipal and provincial levels in 2 selected provinces, of two (2) different regions; plus, Davao Region. b) Amplification of the effective approaches 1 This approach combines three synergistic elements- enhanced health governance, improved supply of health services and increased demand for health services- in order to improve access to and utilization of quality maternal and newborn health services, and with the overall goal of reducing maternal and newborn deaths in the Davao region. developed for a nation-wide implementation of UHC into a smaller, manageable, group of HCPNs with triangulation of financial, technical and managerial integration at each project site. This model will be supported by maternal and child health care model which will enable the health care provider networks within the province to deliver the complete continuum of MCH care, according to population needs (technical integration) while ensuring the strengthening of health systems and financial protection through managerial and financial integration. In the start-up phase, the project signing will be followed by an intense period (first six months) of WHO-DOH project briefings and consultative interactions at the national, regional and provincial level. Consultations will also be held with other stakeholders including development partners. Selected project provinces and municipalities will be profiled to understand their health situation. Policy plans and activities will be reviewed to develop an overview of the environment in which the project will be implemented. In the same time, on the development of the monitoring and evaluation framework and collection of baseline data will be initiated. The project itself will be implemented through an iterative process at two levels: At the regional level, regional project teams (WHO and DOH counterparts) will work with select provinces and municipalities to successively EXPAND preexisting experience in linking HCPNs to communities (based on KOICA-DOH-WHO SNI phase I and partner activities) to the broader UHC agenda and scale those up across the Region. This process will start with health system assessments and health summits to share the information and develop health plans based on this in each of the target province with its municipalities. Work will also be started on the development of tools- related to governance, capacity building and community involvement- necessary for fostering an HCPN-community linkage. Once the tools are developed, training will be undertaken to enable the DOH- Center for Health Development (CHD) and LGUs to use these tools and project implementation will start using these tools. Capacity building of select health institutions and health personnel will also start in this period. Work on strengthening the electronic medical record system (EMRS) will be started in this period. The focus in the second year will be on implementation of the PAS and other approaches developed for PHC in all the selected municipalities in the three provinces. Simultaneously, work will start on institutionalizing these approaches at the LGU level. Toolkit development work will start as means to ensuring the replication of the approaches developed to the regional level. Capacity building of health personnel on different aspects of PHC will continue. Post-training evaluations, assessments (primarily includes EENC Assessment Modules 3,4,5) and supportive supervision will follow the training. At the community level (including IP communities), awareness building and development of community-based support systems for utilization of PHC services will be the big focus. Simultaneously work will be undertaken to make the facilities more responsive to the cultural needs of the IP and other communities. Capacity building on the EMRS will be augmented with training on improved data collection, monitoring and evaluation of data. At the regional level, the national project team (WHO and DOH counterparts) will develop existing DMO meetings into a sustainable, regular capacity building platform that will help to AMPLIFY provincial level experience throughout the region. In the initial phase, such experience will draw on tools and guidelines that have already been developed (e.g. MNH related tools by KOICA phase I, the European Union, USAID, Zuellig). As the project progresses, this platform will take up additional effective strategies from the provincial work, in particular with regard to expanding community linkages beyond MNH to the broader HCPNs. In the course of the first 6 months a capacity building approach will be developed that institutionalizes orientation and coaching sessions for DMOs and PHOs in connection with their regular meetings for each of the three DOH Regionals. These will be continued throughout the project period (and subsequently continued as part of the regular national programme). As of the 2nd project year, regular bi-annual consultations and meetings with national DOH officials will be held to share project learnings and identify strategies and tools with national applicability. Year three of the project will focus on completing and consolidating all the activities initiated in the earlier years and sharing the experience and learning regionally - and proven- effective strategies and tools developed under the project will be integrated into regional and probably national directives. Year four of the project will be used for doing an end line study that captures the project performance and achievements, both qualitatively and quantitatively. This will be followed by dissemination and wrap-up activities. In line with these efforts, the SNI Project Phase 2 would require a baseline study to better reflect the current situation in the selected project sites. While baseline data for key outcome indicators are available from secondary sources (electronic Field Health Information Systems {eFHSIS} and Integrated Clinic information System {iClinicSys}) down to the provincial level, there is a need to further disaggregate this data for CCT, non-CCT households, age, etc., down to the district and LGU levels. The baseline data will principally be used for two purposes: 1) to serve as the basis to assess the contribution of the project in improving the MNCAH indicators of the target provincial project sites relative to the broader regional situation; and 2) to serve as the basis for effective targeting and calibration of interventions. 3. Timeline The implementation timeline for the project is from 15 September 2020 to 15 December 2021. 4. Place of Assignment