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Annex-A TERMS of REFERENCE for INSTITUTIONAL CONTRACT

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Annex-A TERMS of REFERENCE for INSTITUTIONAL CONTRACT Annex-A TERMS OF REFERENCE FOR INSTITUTIONAL CONTRACT (above US$ 2,500) Title of the assignment Installation, commissioning and maintenance of Liquid Medical Oxygen (VIE) System in 30 selected hospitals of Bangladesh to improve oxygen supply for management of COVID patients Purpose Hiring engineering technical company qualified to provide site assessment, design and site supervision services, including safety compliance and quality assurance for the Installation, commissioning and maintenance of Liquid Medical Oxygen (VIE) System in 30 selected hospitals of Bangladesh to improve oxygen supply for management of COVID patients. Location Dhaka, Chottogram, Comilla, Brahmanbaria, Chadpur, Feni, Noakhali, Rangamati, Madaripur, Shariatpur, Narshingdi, Narayanganj, Mymensingh, Netrokona, Barisal, Patuakhali, Rangpur, Kurigram, Dinajpur, Panchagar, Rajshahi, Pabna, Naogaon, Joypurhat, Khulna, Jessore, Satkhira, Moulvibazar, Sunamganjof Bangladesh. Estimated Duration Total project duration is 06 months from the signing of contract - 4 months for the installation, commissioning of LMO system - 6 months for operations, preventive and repair maintenance 1. Background WHO declared Covid19 a worldwide pandemic on 11th March 20201 while Bangladesh reported its’ first positive case on 8th March. There were 52,445 confirmed cases of COVID-19 in Bangladesh as of 2 June 2020, of whom 11,120 persons have recovered and 709 died. Till date all districts of Bangladesh have reported confirmed Covid-19 cases and the country has been categorized as Cluster of cases with Dhaka City being the worst affected followed by Chattagram, Narayanganj, Comilla, Munshiganj, Gazipur, Noakhali, Kishorganj, Coxs’ Bazar etc. These districts along with their adjacent districts are now regarded as the epicenters of the COVID in Bangladesh. Given the unprecedented nature of SARS-COV-2, the virus that causes COVID-9 disease, any district might become the new epicenter and pose a great risk for overwhelming the health facilities/hospitals with COVID cases. While most people with COVID-19 develop only mild illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit 2. Most of the severe and critical COVID cases would require high flow oxygen support and the requirement 1 a) Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta bio-medica: Atenei Parmensis. 2020;91(1):157-60. b) Spinelli A, Pellino G. COVID-19 pandemic: perspectives on an unfolding crisis. Br J Surg. 2020;10. 2 Surveillances V. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Weekly. 2020;2(8):113-22 1 | P a g e of oxygen for the projected number of cases at district, divisional and tertiary level hospitals may far exceed the current capacity. The burgeoning number of COVID cases has already over stretched the case management capacity of the designated hospitals which have been further accentuated by the inadequate oxygen supply at all level of hospitals. In Bangladesh all the upazilla and district level hospitals don’t have oxygen generation capacity and largely depends on supplied oxygen cylinders. Even though some of the medical college hospitals and tertiary level hospitals have either Liquid Medical Oxygen (Vacuum Insulated Evaporator-VIE) system or small numbers of PSA (Pressure Swing Adsorption) system, however those are not sufficient to cater the increasing demand of oxygen with high flow for managing the COVID cases as per national Case Management guidelines. Thus for effectively managing the COVID cases, all hospitals at district, divisional and tertiary level managing large numbers of severe and critical cases should have high flow oxygen with surge capacity through oxygen generation system (PSA or LMO) and backed-up by adequate oxygen distribution through pipelines and cylinders. Meanwhile Oxygen concentrators are only suitable to manage severe cases who require <10LPM oxygen and may be considered mainly for the Upazila Health Complexes and other facilities as per requirement. In alignment with the National Preparedness and response Plan and as one of the strategic priority for COVID case management, DGHS has already assessed the facilities in terms of oxygen capacity and developed a plan for further strengthening the oxygen supply system in all designated hospitals who will be managing COVID/Non-COVID cases. As per the expert opinion from the relevant technical agency who are operating in Bangladesh, establishing a new LMO system may take 4 weeks time while installation of a PSA (Pressure Swing Adsorption) oxygen generation system may take more than 7-8 weeks time and depends on timely offshore procurement, shipment, clearance etc. In the context of current situation and urgency, DGHS has prepared a list of facilities for installation of Liquid medical oxygen (LMO) system and also increasing capacity of the existing LMO system with extended outlets to surge the oxygen supply capacity of all hospitals within shortest possible time period. A circular in this regard has also been dispatched from the Ministry of Health for immediate installation of LMO system and increase capacity of the existing LMO system in selected hospitals on a priority basis. UNICEF steered an analysis and projection of oxygen requirement by different level of facilities in March 2020 and conducted policy advocacy for immediate strengthen of oxygen capacity in all designated hospitals, which prompted the DGHS, MOHFW and other partners to take affirmative actions in this regard, which also positioned UNICEF as a trusted development partner to manage and implement Oxygen supply system through a third party technical agency. 2. Objectives, Purpose and Expected Results Objectives and Purpose of Assignment – The objective of this project aims to improve the capacity of the health facilities for management of COVID-19 cases through upgradation of Oxygen supply system as per national management protocol. Within the framework of Bangladesh National Preparedness and Response Plan (BNPRP), UNICEF is looking at hiring an engineering technical company qualified to provide site assessment, design and site supervision services, including safety compliance and quality assurance for the Installation, commissioning and maintenance of Liquid Medical Oxygen (VIE) System in selected hospitals of Bangladesh to improve oxygen supply for management of COVID patients. 2 | P a g e Specific services under this assignment are as follows: ▪ Initial Site assessment, including physical structural analysis; ▪ Building design (including mechanical, electrical, plumbing and safety); ▪ Detail Technical Specifications in compliance with MOHFW’s guidelines; ▪ Safety and regulation compliance plan; ▪ Permitting; ▪ Installation, Testing & Commissioning of Liquid Medical Oxygen (VIE) System including extended medical gas distribution channel and outlets; ▪ Site supervision and quality assurance ▪ Preventive maintenance, trouble shooting, repair-maintenance ▪ Operational plan including shared responsibility with hospitals in terms of oxygen storage, replenishment and reserve supply etc. 3. Description of Assignment Scope of Work – The technical agency will coordinate with DGHS, NEMMU, PWD, UNICEF and other concerned agencies for the installation of new Liquid Medical Oxygen (VIE) System in ten (10) hospitals and strengthening capacity of existing LMO system with extended pipeline and gas outlets in ten (10) hospitals as per the list underneath as per the guidelines and specifications set by the DGHS/MOHFW. Description of tasks: a. Initial Site assessment, Physical structural analysis; Detail Technical Specifications in compliance with MOHFW’s guidelines, detail design (including mechanical, electrical, plumbing and safety); Prepare detail Project Implementation Plan along with detail site-based workplan and Team mobilization plan and BOQ; b. Prepare Safety and regulatory compliance plan and ensure its’ compliance in accordance with the government’s regulatory requirement, relevant codes and as per the standard industrial practices and standards; c. Carry-out physical works for the installation of Liquid Medical Oxygen (VIE) System in accordance with all applicable local codes, standards, rules, regulations, and laws including, but not limited to, the codes and standards referenced in the detail agreed Specification (to be annexed); d. Installation, Testing & Commissioning of Liquid Medical Oxygen (VIE) System and strengthening capacity of existing LMO system with extended pipeline and gas outlets ( O2, Air, Vacuum for ICU beds and only O2 for Non-ICU beds as per DGHS requirement list) in total 30 Hospitals in two phases as per the list provided underneath and in accordance with all applicable local codes, standards, rules, regulations, and laws including, but not limited to, the codes and standards referenced in the detail agreed Specification (to be annexed); 3 | P a g e e. Develop detail operations, maintenance and site supervision and quality assurance plan which includes but not limited to adequate supply chain with measure and control devices for periodic check for purity, pressure and consistency of oxygen; Based on information shared by Director Hospitals of DGHS, there are 81 hospitals that require new liquid oxygen system and/or expansion the existing system (list provided in Annex. Of this, thirty hospitals have been selected (table 1 and Annex A.1) where UNICEF will be providing
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