Digitalize Immunization: e-Tracker and eVLMIS

Institutional Contractor

Title

Digitalize Immunization: e-Tracker and eVLMIS

Purpose

• Strengthen health institutions and networks, including the routine immunization (RI) e-Tracker and vaccine management systems to interface with the COVID-19 module to generate electronic routine vaccination cards by developing mentorship/supervision and monitoring tools and creating a linkage between the two registries and enhance the immunization e-Tracker software to make it user-friendly, comprehensive enough in capturing critical additional information, and inclusive for health providers, including through improved interfaces, adaptive checklists, and enabling provision of electronic vaccination cards.

• Scale-up implementation of the integrated routine and COVID-19 vaccine tracker including user-testing for refined e-tracker and capacity building of the health workforce on the use of the e-tracker and vaccine management system,

• Dissemination of key immunization documents and information through innovative to digitize paper systems and deploy an appropriate e-vaccine management system through District Health Information System 2 (DHIS2) and conduct capacity-building of immunization staff and managers at all levels to interpret, triangulate and use data for action.

Type of consultancy: Delivery based

Location Rwanda (central level to vaccination points)

Duration 10 months

Start Date 1 June 2023

Reporting to UNICEF Rwanda, Health and Nutrition Section

• Background

Rwanda started an expanded Program on Immunization (EPI/Rwanda) in 1978, which developed rapidly, in 1980 the EPI was operational with six routine vaccines BCG, OPV, DPT, TT, and Measles vaccine. In 2002, the program introduced the pentavalent vaccine, a DPT-containing vaccine (DPT-HepB+Hib), given to all children at the same time as the oral polio vaccine (OPV). In April 2009, a new vaccine, pneumococcal conjugate vaccine (PCV) was also introduced to National Immunization Program. In 2011, the HPV vaccine was added to the routine immunization program to protect adolescent girls from cervical cancer using a school-based immunization approach at the beginning and shifted to an age-based approach (12 years) in 2014. In May 2012, EPI introduced one more life-saving vaccine, the rotavirus vaccine, into its routine program and, finally, in January 2014, the rubella vaccine combined with Measles/Rubella vaccine was introduced in routine immunization and given at nine-month and MCV as measles second dose at fifteen months. IPV 1st dose and 2nd dose were introduced in 2018 and 2022 respectively. Paper-based recording in immunization services requires an exorbitant budget for the production of vaccination cards, vaccination registers, and vaccine stock management cards, and also much time for filling the above tools. Data quality and accessibility issues are not exempted if using paper-based records. Considering that Rwanda is promoting the digitalization of public services including health services; since 2020, the immunization program has launched the vaccination individual electronic registry “immunization e-tracker system” being used in all health facilities providing vaccination services.

• Justification

Following the Ministry of Health instruction; since October 2022, all HFs should fully shift from paper-based recording of vaccination data to an immunization e-tracker system. However, we observe some of them who continue to use both vaccination registers and e-tracker systems which affect the quality of the data recorder in the e-tracker system. In addition, data analysis shows quality issues that need to be handled by setting specific features for data quality checking.

For improving vaccine and vaccine device management, the immunization program is initiating Vaccine Management Information System (VMIS). Currently, this system is being used by all HFs for vaccine and vaccine device request and distribution only. Used features for request and distribution have many challenges which affect the validation of stocks at all levels of the system and there is no possibility to generate reports on vaccine management.

It is against this background that the Ministry of Health/Immunization program is requesting UNICEF as the main immunization partner to support the improvement of the 3 immunization e-tracker system and VMIS systems and continue supporting health providers on the use of these systems. •

Objectives

The main objective of this technical assistance is to make more operational the immunization e-tracker and Vaccine Management Information systems to make them user-friendly and inclusive for health providers, including through improved interfaces, adaptive checklists, and enabling provision of electronic vaccination cards, setting all required features, making them interoperable with other systems having same information and training of health provider on effective system use.

Specific objectives include:

• Integrate the electronic immunization registry with vaccination campaigns like COVID-19 tracker, nutrition,

• Improve reporting and performance review at the national, district and health facility levels through the institutionalization of performance and accountability of tools. • Strengthen and streamline immunization administration and reporting through e-tracker software.

• Improved efficiency in terms of the flow of care for immunization at all targeted facilities.

• Improve data use-related capacity and tools available at all levels and improved capacity to detect and respond to adverse events.

• Streamline the immunization supply chain and improved the efficiency of vaccine management, logistics, distribution, and reporting systems (eVLMIS)

• Improved immunization service delivery and immunization supply chain performance through the use of data for supervision and action.

4. Description of the assignment/specific tasks

1. Desk review and preparation of inception report Gather and collate background information on e-tracker and Vaccine management system implementation and submit the final inception report.

2. Immunization e-tracker system

i) To identify all system-related challenges and fix them for making it user-friendly.

ii) To configure analytical features allowing quick identification of outliers or any other quality issues.

(iii) To configure features allowing to send short message service (SMS) reminders to parents or caretakers of the vaccination appointment date and missed appointments.

(iv) To develop an electronic vaccination card which includes growth monitoring information in an integrated manner.

(v) To ensure the system captures weight and length at birth (vi) To improve integration of RI and nutrition like VitA, deworming, and growth monitoring and improve interoperability of e-tracker system with Civil Registration of Vital Sign (CRVS) and configure features allowing analysis or identification of vaccinated and non-vaccinated children into the birth registration system.

(vii) To configure and improve instances allowing registration of vaccinated children during specific events like vaccination campaigns like Covid-19 or recent coming refugees.

(viii) On request of the Vaccine Program Unit; configure an automatic reporting system so that immunization e-tracker system data will automatically feed the HMIS system on monthly basis without manual report preparation.

(ix) Create a comprehensive web-based dashboard (scorecard) of individual and aggregate immunization data

(x) Prepare a user manual document in both PDF and video showing all steps of e-tracker registration and data analysis.

(xi) To be ready to technically support system users and staff based on the raised issues.

(xii) In collaboration with Vaccination Program; organize training of immunization program staff and health providers on effective use of the e-tracker system: correct registration including offline mode and data analysis.

(xiii) In collaboration with Vaccination Program; organize onsite supportive supervision of health providers to identify system-related challenges.

(xiv) Collaborate and respond to the program request or need aiming to improve the immunization e-tracker system in its aspects of recording and data analysis.

3. Vaccine Management Information System

(i) To organize a consultative meeting with representative staff from RBC/Vaccine program unit, district hospitals, and health centers on quarterly basis for the identification of needs and challenges related to eVLMIS.

(ii) To improve the eVLMIS for effective vaccine and vaccine devices request, distribution and reporting.

(iii) To make effective system use by configuration of analytical features and reports production.

(iv) Prepare a user manual document in both PDF and video showing all steps of eVLMIS use including reports generation. (v) In collaboration with Vaccination Program; organize training of health providers on effective use of eVLMIS: correct request preparation and submission, correct acknowledgement of products, reports production and data analysis including checking of probable errors.

(vi) To be ready to technically support system users staff based on the raised issues. In collaboration with Vaccination Program; organize onsite supportive supervision of health provider in order to identify system relative challenges.

(vii) Collaborate and respond to the program request or needs aiming to improve the eVLMIS in its aspects of vaccine management, stocks analysis and reports production.

4. Knowledge Management and Capacity building

(i) Conduct testing of new tracker interface for refinement and capacity building of health workforce (500) on use of the e-tracker and vaccine management system and

(ii) Conduct capacity building of immunization staff and managers at all levels to interpret, triangulate and use data for action

(iii) Dissemination of key immunization documents and information through innovation to digitize paper systems

5.Key deliverables and timelines

Activity Deliverables Timeline Schedule of Payment

TASK 1 Desk review and preparation of inception report including challenges in the implementation and ways for improvement(e-tracker and eVLMS) One month 10% payment upon receipt of final deliverable

TASK2 Strengthen immunization e-tracker system Three months 25% payment upon receipt of 6 Minutes of the dissemination meeting with RBC and MOH senior managers final deliverable

TASK 3 Strengthen vaccine management system into a proper eVLMIS Two months 25% payment upon receipt of final Minutes of the dissemination meeting deliverable with RBC and MOH senior managers

TASK 4 Conduct testing of new tracker interface for refinement and capacity building of health workforce (500)on use of the e-tracker and vaccine management system Two months 10% payment upon receipt of final deliverable Conduct capacity building of immunization staff and managers at all levels to interpret, triangulate and use data for action Dissemination of key immunization documents and information through innovative to digitize paper systems

Final report The end product will be the final report which should be in line with UNICEF and MOH standards and specifically, should include but not limited to the executive summary, description of major tasks aforementioned with status level of their achievement. To be submitted simultaneously with the deliverable for TASK 3 20% payment upon receipt of final deliverable

Retention Payment Final approval by MOH and RBC on the functionality of the 2 systems based on the expectations detailed in this TORs One month 10% payment upon receipt of final Government approval

The institutional consultant will collaborate with RBC, Ministry of Health and other government institutions as well as sector partners to collect necessary data and information to deliver on the above listed outputs.

The consultant will submit brief monthly progress updates to RBC/ and UNICEF along with completed deliverables listed above as per agreed timelines.

• Reporting Requirements

Please refer to section 5 “expected deliverables” for the reporting requirements.

• Project Management

The Consultant will be contracted by and report to UNICEF Rwanda. In addition, the consultant will report to RBC and MOH, the lead agency for immunization and digitization of health systems.

• Location and duration

Though some tasks under this study may be carried out remotely, most of the field work will be carried out in Rwanda. In this context, the key technical team members will have to work within the country to undertake field visits/work, meeting with partners and workshop/training facilitation.

• Payment Schedule

Payment will be made to the institutional consultant as per scheduled presented in Section 5.

• Qualifications

The following minimum requirements are necessary for a successful bid:

(i) Legal entity/consortium of legal entities.

(ii) At least 10 years of demonstrated experience of managing and implementing immunization digitization

(iii) Experience of working in African countries, especially in Rwanda.

The Consultant should propose a suitable team, including team leader and relevant experts including health digitization with specific knowledge in immunization e-tracker and eVLMIS Expert. The proposed team leader should possess a Masters’ degree in health technology and at least 10 years of relevant professional experience. The other team members should possess a Masters’ degree in health technology, and at least 8 years of relevant professional experience in immunization digitization. The Team Leader role may be assigned to one of the proposed technical experts.

• Evaluation Methodology a. Technical Proposal: The consultants should submit a Technical Proposal that should include, but not limited to:

(i) Firm’s registration certificate.

(ii) Two latest audit reports;

(iii) Financial details including annual turn-over (in US Dollars) for the past 3 years;

(iv) Firm’s organization and experience (including title of the assignment, name of the client, year and duration, scope of the assignment, outcome of the assignment, and reference/contact persons name, email and telephone);

(v) Comments and suggestions on the terms of reference;

(vi) Methodology and work plan for performing the assignment; (vii) Team Composition and task assignments;

(viii) CVs for proposed professional staff (name, date of birth, years with the firm, total years of experience, nature of experience in this firm and others, education/other trainings and knowledge of local languages);

(ix) Time schedule for professional staff;

(x) Activity (work schedule);

(xi) Any dependencies or assumptions; and

(xii) Copies of at least two reports or samples of previous tasks like these under these terms of reference undertaken by the consultancy firm.

The submission should be clearly labelled/written "Request for Proposal – digitalize immunization program - Technical Proposal”.

(a) Financial proposal The Financial bid should comprise an indication of the full cost of delivering the task. The Financial Bid should include breakdown of professional fees/remuneration, reimbursables and miscellaneous expense etc. (see Annex-1 for the suggested template). The submission should be clearly labelled/written “Request for Proposal – digitalize immunization program - Financial Proposal”. The currency of the bid shall be in USD or RWF.

(b) Assessment processes of submitted proposals: After the opening, each proposal will be assessed first on its technical merits and subsequently on its price. Responses deemed not to meet all of the requirements listed above will be considered non-compliant and rejected at this stage without further consideration. Failure to comply with any of the terms and conditions contained in this ToR, including provision of all required information, may result in a response or proposal being disqualified from further consideration. Final decision on the evaluation/proposal assessment will rest with UNICEF.

(c) Evaluation of technical proposals

 The technical proposals will be evaluated as per the below evaluation criteria:

Technical Proposal No. Criteria Max. Points

1.0 Overall response 5

(i) Overall clarity and completeness of the proposal. 2

(ii) Overall concord between the RFP requirements and the proposal 3

2.0 Proposed Approach, Methodology and Workplan 30

(i) Adequacy of the proposed implementation approach/ methodology 15

(ii) Structure of the team to be deployed for the assignment 5 (iii) Workplan 5

(iv)Monitoring and coordination mechanism 5

3.0 Organizational Capacity 35

(i) Organizational expertise and experience in works of similar nature and complexity completed over a minimum of five(5)years 5

(ii) Qualifications and competence of the key staff 30

Total 70

Only proposals which receive a minimum of 49 points under the technical evaluation will be considered technically compliant and be eligible for the second phase (financial review).

(d) Evaluation of financial proposals The total amount of points allocated for the price component is thirty [30]. The maximum number of points will be allotted to the lowest price proposal that is opened and compared among those invited firms/institutions which obtain the threshold points in the evaluation of the technical component. All other price proposals will receive points in inverse proportion to the lowest price e.g.:

Max. Score for price proposal * Price of lowest priced proposal Score for price proposal X = -----------------------------------                Price of proposal X

(e) Final computing of proposal score Total proposal scores will be consolidated as follows:

Evaluation of proposal Maximum points

Technical evaluation of proposals 70

Cost / Financial proposal 30

Total 100

The proposal with the best overall scoring, composed of technical responsiveness, merit and price, will be recommended for approval. UNICEF will notify the selected firm/institution by email when the evaluation and award process is completed. •

Supervision

The consultancy firm will work under the joint supervision of the UNICEF Rwanda health and Nutrition section and the MOH/RBC.

• Confidentiality

Unless otherwise specified, the consultant shall keep confidential all information and documentation being shared by UNICEF and all participant government institutions or partners

•Contract management and administrative matters

UNICEF will issue the contract and pay the consultants, based on the terms agreed in the contract and after the approval of the deliverables by RBC and MOH.

The consultant will be responsible for all logistical arrangements associated with this contract. UNICEF /RBC will provide a letter of support to facilitate obtaining visa and for the purpose of field visits where needed (for quality assurance). Other expenses such as international and local travels, visas, banking/cash services, or office space and equipment (including computers and photocopiers) shall be under the responsibility of the consultant.

•Policy issues

(i) No contract may commence unless the contract is signed by both UNICEF and the consultant;

(ii) Consultants will not have supervisory responsibilities or authority on UNICEF budget; and

(iii) UNICEF will conduct reference checks (persons/institutions) for feedback on services provided by the bidder.