LRPS-2024-9193236 Implementation research to understand the relevance, appropriateness, effectiveness for Mother- Special Care Newborn Unit in Bangladesh"

TERMS OF REFERENCE FOR INSTITUTIONAL CONTRACT

 

  Implementation research to understand the relevance, appropriateness, effectiveness for Mother- Special Care Newborn Unit in Bangladesh

 

          Study (an initiative to establish current knowledge around a specific topic through the descriptive summarization, interpretation or assessment of information and data)

          Research (systematic process of the collection and analysis of data and information, in order to generate new knowledge, to answer a specific question or to test a hypothesis)

          Evaluation (rigorous, systematic, and objective process in the design, analysis and interpretation of information to answer specific questions)

 

Purpose

To implement and analyse the implementation process of Mother-Special Care Newborn Unit (M-SCANU) determining relevance, appropriateness, patient burden & sustainability.

Location

Dhaka District, Cox bazzar and Bhola District

Estimated Duration

1st Oct,2024-30th June,2025

Technical Supervisor of the assignment

Health Specialist (Newborn and Child Health)

 

1. Background and Context

 

Low birth weight infants, i.e., infants with a birth weight less than 2.5 kg constitute approximately 15% of all newborns worldwide but account for 70% of all newborn deaths[1]. Most of these babies are born in low and middle-income countries (LMIC) in Asia and sub-Saharan Africa and die within the first days of life. Reducing mortality among these infants is the key to achieving the United Nations Sustainable Development Goals target of reducing newborn mortality to as low as 12 deaths per 1000 live births by 2030.

Maternal and child health remains a critical component of global health priorities, particularly in low- and middle-income countries (LMICs) where the rates of maternal and neonatal morbidity and mortality are disproportionately high. Ensuring the survival and health of both mothers and newborns is essential for fostering healthy communities and enhancing the overall well-being and economic stability of societies. In this context, innovative care models such as Mother-Special Care Newborn Unit (M-SCANU), Special Care Newborn Unit (SCANU), Newborn Stabilization Unit (NSU) and Kangaroo Mother Care (KMC) have emerged as pivotal interventions aimed at improving neonatal outcomes.

 

Despite notable progress in health status, there is high rate of newborn death in Bangladesh which is 20 per 1000 live birth (BDHS 2022), which means, near about 68,000 newborn dies every year before completing their first month of life. This large number of deaths occur mainly for following causes which are prematurity, low birth weight, birth asphyxia, and infection. 40% of these deaths are preventable with Kangaroo Mother Care (KMC). KMC is an evidence-based, no-cost intervention that promotes continuous skin-to-skin contact between the mother and her newborn for a prolonged period. This method has been shown to enhance thermal regulation, increase in breastfeeding, and bonding, thereby improving neonatal survival rates and overall health outcomes empowering mothers and families to continue this critical care beyond the confines of the hospital. WHO previously recommended KMC when the infant’s clinical condition has stabilized, which is normally achieved 3 days after birth. However, approximately 45% of newborn deaths occur within 24 hours of birth and 80% during the first week of life. Thus, majority of deaths among newborns with low birth weight typically occur before Kangaroo Mother Care can be initiated. Additionally, these newborns are at higher risk of developing various illnesses requiring special care in a dedicated intensive newborn care unit. Those who survive are more likely to develop growth-related and neurodevelopment problems than babies born with normal birth weight.

 

Mother–Special Care Newborn Unit (M-SCANU) is a unit inside the hospital/health facility where sick and small newborns are taken care of by their mothers on a 24×7 basis. Such an area can be created in hospitals/health facilities that provide special newborn care, i.e., care to small and sick newborn babies who does not require ventilation support. Most babies requiring special newborn care can be managed with mothers in M-SCANU, and 80-85% of babies requiring care in SCANU are not critically sick, can be managed with mothers in M-SCANU.

 

WHO recently published new recommendation for care of the preterm and Low Birth Weight (LBW) babies with strong recommendation to start KMC for all preterm or LBW babies below 2500 gm as soon as possible after birth. New research has suggested that KMC initiated immediately after birth followed by continuous KMC, aiming for more than 20 hr/day improves newborn survival by 25%. This multi-country research was coordinated by the World Health Organization in five countries: Ghana, India, Malawi, Nigeria, and Tanzania.

 

The implementation of continuous KMC intervention required mothers to be with their small and sick newborns on a 24x7 basis in Special Care Newborn Unit (SCANU), against the present norm of separating sick newborns from their mothers. This led to a restructuring of the existing newborn intensive care unit to accommodate the mother allowing her to stay with the baby, and hence the intervention of iKMC led to the innovation of “mother–Special Care Newborn Unit (M-SCANU)”.

 

The Mother SCANU (Special Care Newborn Unit) initiative in Bangladesh, focuses on improving maternal and newborn health by establishing specialized care units within hospitals. This initiative aims to provide comprehensive medical support for managing complications during childbirth and the neonatal period. By equipping healthcare facilities with essential medical equipment and training healthcare professionals, Mother SCANU enhances the quality of care for high-risk pregnancies and newborns in critical condition. Additionally, it facilitates the development of standardized protocols and practices across various healthcare settings to ensure consistent and effective care. This initiative is crucial in reducing infant mortality rates and promoting the well-being of mothers and their babies, setting a model for improved healthcare services across the country. Currently in Bangladesh, there are around 3 districts in which the M-SCANU had piloted with technical support from UNICEF, WHO and NNHP-IMCI under LD-MNCAH with reflections from global context. However, national guidelines that are responsible for overall guidance of M-SCANU is yet to develop.

 

1. Rationale / Purpose of the evidence activity

 

It is implementation research, conducted as systematically, of newly implemented M-SCANU implementation status in term of strategy, guideline and institutional performance. Implementation research should provide credible, useful evidence-based information that enables the timely incorporation of its findings, recommendations, and lessons into the decision-making processes of organizations and stakeholders.

 

This research is essential to provide policymakers, healthcare managers, and program implementers with robust evidence to optimize and scale up effective neonatal care interventions.

 

1. Necessity:

Approximately 45% of newborn deaths occur within 24 hours of birth and 80% during the first week of life. Thus, majority of deaths among infants with low birth weight typically occur before Kangaroo Mother Care can be initiated. In Bangladesh, it is often observed that the SCANUs have high bed occupancy rate and often multiple newborns are treated in one single cot at the same time. Thus, these vulnerable newborns with low immunity are susceptible toward developing various hospital acquired infection while seeking care inside the newborn care unit. Those who survive are more likely to develop growth-related and neurodevelopment problems than babies born with normal birth weight. WHO conducted recentmulti-country study showed that babies with mother in Newborn Care Unit (NCU) had 35% less incidence of hypothermia and 18% less suspected sepsis as compared to babies without mother in conventional NCU.Several possible positive factors outlined for the lower risk of infections, including increased breast milk feeding, lower risk of cross infection since one mother cares for only her baby rather than a nurse caring for 8–12 babies, and colonization of the baby with bacteria from the mother’s microbiome rather than the NICU environment. With this study findings and WHO new recommendation, Bangladesh started the pilot implementation of M-SCANU in some of the existing SCANU (Bhola and Dhaka) for better outcome of preterm or small sick newborn.

Implementation research for the Mother SCANU initiative is essential to gather insights on how the program is functioning, ensuring it meets the needs of the community and sets a standard for future projects. This research helps refine service guidelines, enhancing the support and care provided to mothers and newborns.

 

1. Key Gaps in Knowledge:

There are critical gaps in the understanding of M-SCANU set up, relevance and others in addressing small & sick newborn health care and re-infection rate for discharge babies from SCANU. Specifically, there is limited to zero empirical evidence on the comparative effectiveness of these interventions in Bangladesh country context, which is vital for crafting targeted healthcare policies. Additionally, real-world data on the feasibility, sustainability and scalability of these interventions are needed to inform future program expansion and funding decisions.

 

1. Why Now:

Conducting this implementation research at this juncture is particularly timely given the increasing global and national focus on achieving the Sustainable Development Goals (SDG), particularly target 3.2 which aims to end preventable deaths of newborns and children under five by 2030. To reach the SDG target for newborn, we need to strengthen interventions for small and sick newborns with innovative and effective approaches to reduce death in first week of life and M-SCANU is one of the proven interventions recommended by WHO. Furthermore, the recent expansion of maternal and child health programs in Bangladesh, provides a unique opportunity to evaluate these interventions under actual implementation conditions. The results of this implementation will be instrumental in refining current strategies, ensuring resource allocation is evidence-based, and potentially guiding policy adjustments to enhance impact and cost-effectiveness.

 

The research aims to fill significant knowledge gaps and provide actionable insights that can be used by healthcare administrators, policymakers, and international health organizations to improve neonatal care practices and outcomes. The implementation research findings will help to shape more effective, context-specific strategies for both home and facility-based newborn care, ultimately contributing to reduced neonatal mortality and long-term health improvements for the most vulnerable populations.

 

3. Objectives

 

The objective of this implementation research is to assess the relevance, appropriateness, implementation challenges and sustainability of sick, pre-term and/or low birth weight baby in Bangladesh. By systematically analysing these care models, the research aims to:

 

• To document implementation challenges and measures to overcome those for effective implementation
• To understand the hospital-stay, recovery rate & hospital acquired infection rate and other essential outcomes of newborns admitted in M-SCANU and those who admitted to conventional SCANU.
• To assess whether involvement of mothers in the care of their sick newborns is beneficial to improving baby’s health outcome
• To identify barriers and facilitators to the successful implementation of this research model
• Provide evidence-based recommendations for policymakers, healthcare managers, and community health workers to enhance the integration, sustainability and scale up of M-SCANU.

 

4. Scope

 

The selected organization will be responsible for the following tasks, which are crucial for the evaluation and analysis of Mother-Special Care Newborn Unit (M-SCANU) and follow-up the newborn discharged from Mother-Newborn Care Unit (M-SCANU)

 

• Desk Review: Conduct a comprehensive desk review of existing guidelines, treatment protocols, and training modules related to SCANU, KMC and community follow-up care for M- SCANU discharged babies. This includes examining documents from both national and international sources to understand current best practices and identify gaps in the existing literature.

 

• Technical support: development of SOP and implementation guideline on M-SCANU through contextualize WHO training module and discussion with professional bodies and other implementers in Bangladesh. Provide capacity development using developed SOP and guideline on M-SCANU to all level of service providers and health managers including Bhola and national program office.

 

• Implementation support: provide technical assistance to local health managers and service providers for the successful implementation of M-SCANU through regular monitoring and on job support.

 

• Active Data Collection: Carry out extensive data collection activities, incorporating both quantitative and qualitative methods. This will be conducted at both national and sub-national levels, encompassing various geographic areas that are representative of the broader population. Specific focus will be on regions with active M-SCANU programs to gather relevant and diverse data. For addressing the comparison of research question, selected organization need to identify and compare conventional SCANU units to evaluate differences in neonatal outcomes effectively, ensuring a comprehensive analysis in this comparative study.

 

• Key Stakeholder Interviews: Facilitate interviews with key stakeholders, including healthcare providers & managers, program implementers, government officials, Caregivers and other stakeholders. These interviews aim to gather deep insights into the implementation, challenges, and perceived effectiveness of M- SCANU interventions.

 

• Data Analysis: Perform rigorous data analysis to produce scientific evidence on the effectiveness of the two care models. This analysis will encompass various aspects of the interventions, such as immediate health outcomes, cost-effectiveness, economic evaluation, enablers, and implementation challenges, for different target groups, including infants discharged from conventional SCANU.

 

• Comprehensive Report: Develop a detailed report summarizing the findings of the research. This report will cover the methodology, analysis, key findings, and interpretations related to the impact and effectiveness of M-SCANU with comparison to conventional SCANU

 

• Policy Brief Paper: Draft and disseminate a policy brief paper that includes recommendations based on the research findings. This document will also outline a scaled-up plan for enhancing the implementation of M-SCANU intervention, detailing how these evidence-based practices can be integrated into national health strategies.

 

• Publication in peer review journal: Draft and submit the findings of research in peer review journal with renowned impact factor. The selected organization need to follow the UNICEF procedure on publication.

 

1.  

 

1. How does the integration of immediate Kangaroo Mother Care within Mother SCANU effect neonatal health outcomes compared to conventional care methods?
2. What are the key challenges and facilitators in the implementation process of Mother SCANU and immediate KMC in diverse healthcare settings in Bangladesh?
3. How do healthcare providers' knowledge, attitudes, and practices regarding immediate KMC influence the success of its integration into the Mother SCANU initiative?
4. What are the differences in health outcomes, such as survival rates, infection rate and complication incidences, for newborns receiving care in Mother SCANU units compared to those in conventional SCANU units?
5. What is the immediate outcome of immediate and continuous Kangaroo Mother Care in M-SCANU on Low Birth Weight and Premature newborns comparing with conventional SCANUs?

 

6. Methodology

 

The method should describe and provides an explanation of the chosen research question, objectives, overall scope of work which will be used by the selected organization.

6.1 The organization should include the following steps but not limited to:

• Provides a relevant research methodology that is explicitly justified as appropriate for the purpose of the research topic.
• Description of the research methodology, including mainstreaming of gender equality and human rights norms and standards. Gender equality and human rights dimensions need to integrate into all aspect of research as appropriate and/or criteria derived directly from human rights principles are used (e.g., equality, participation, social transformation, inclusiveness, empowerment, etc.)

6.2 Clear and relevant presentation of the framework including:

• Clear methodology to guide the research questions linked, that include standalone and mainstreamed questions of gender equality and human rights.
• Appropriate indicators for each research question
• Gender responsive and human-rights based indicators (disaggregated, gender-specific, gender-distributive, gender-transformative)
• Rubric (reference indicators and benchmarks to denote success are included where relevant)
• A clear link between the indicators and the sources of evidence tools

6.3 Describe the design and methods, the rationale for selecting them, and their strengths and limitations for addressing the research's purpose, objectives, and scope:

• Qualitative and quantitative data collection methods and tools

• Qualitative and quantitative data analysis methods and tools and the links to answering the research questions, including triangulation of multiple lines and levels of evidence (if relevant)
• Reference to the use of a rights-based framework, and/or Convention on the Rights of the Child (CRC), and/or Core Commitments for Children (CCC), and/or the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) and/or other rights related benchmarks in the design of the research.
• Description of how the methods employed are appropriate for analysing gender and human rights issues including child rights issues identified.

6.4 The methodology needs to describe the data sources, the rationale for their selection, and their limitations:

• Sampling method includes discussion of how the mix of data sources was used to: obtain a diversity of perspectives (or if not, provide reasons for this), ensure data accuracy, mitigate data limitations.
• Describes the sampling frame – area and population to be represented, rationale for selection, mechanics of selection, numbers selected out of potential subjects, and limitations of the sample.
• Mixed method approaches to make visible diverse perspectives and promotes participation of women and men, boys and girls, from different stakeholder groups.

 

7.  Ethical Considerations 

The research agency is expected to follow the ethical principles and considerations outlined in the United Nations Evaluation Group (UNEG) Ethical Guidelines for Evaluation and the UNICEF Procedure for Ethical Standards in Research, Evaluation and Data Collection and Analysis. In addition, the UNEG norms and standards will be observed. As per UNICEF standards for ethical research, the evaluation/research agency must give special attention to ethical considerations and should put in place adequate measures for ethical oversight throughout the study/evaluation period. All researchers and field investigators involved in primary data collection should have undergone basic ethics training, which at a minimum includes completing UNICEF’s AGORA course on Ethics in Evidence Generation or its equivalent.

In conducting the study, the research agency must ensure informed consent, respecting people’s right to provide information in confidence and making study participants aware of the scope and limits of confidentiality. Furthermore, the agency is responsible for ensuring that sensitive information cannot be traced to its source so that the relevant individuals are protected from reprisals.  Data storage and security must be ensured at all stages of the study. Only select personnel from the research agency should have access to de-identified data, and only anonymised data should be shared externally, and with UNICEF (unless stated otherwise).”

Ethical clearance is mandatory to obtain the approval from Independent Review Board (IRB) for this research, given it involves data collection with vulnerable populations. The research agency will be responsible for getting necessary IRB approvals for the protocol and other relevant components of the study/evaluation and should factor in the IRB process, from both financial and timeline perspectives.  The proposal and implementation should be informed and guided by UNICEF’s Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis.

 

Ethical issues and considerations are described and guided by the UNEG ethical standards for evaluation. As such, the evaluation report should include:

- Explicit reference to the obligations of evaluators (independence, impartiality, credibility, conflicts of interest, accountability)

- Description of ethical safeguards for participants appropriate for the issues described (respect for dignity and diversity, right to self-determination, fair representation, compliance with codes for vulnerable groups, confidentiality, and avoidance of harm)

- ONLY FOR THOSE CASES WHERE THE EVALUATION INVOLVES INTERVIEWING CHILDREN: explicit reference is made to the UNICEF procedures for Ethical Research Involving Children

 

8. Use of Findings

 

The findings of this research will provide evidence on the effectiveness and impact of the M-SCANU. Based on the generated evidence, appropriate adjustments to implementation will be made if necessary. Additionally, this evidence will be used to advocate to the Ministry of Health & Family Welfare, especially to LD-MNCAH, LD-HSM, LD-UHC, LD-CBHC, including ADG and DG.

 

9. Publication Plan

 

• General Conditions of Contracts for Services: UNICEF entitled to all property rights regarding material created by the Contractor.
• UNICEF owns all rights in the publication and in the underlying data/research.
• In the process of undergoing external academic publication by a UNICEF institutional contractor, then the review and approval process stipulated in the contract will apply. This should normally include a quality assurance review in accordance with the UNICEF Procedure for Quality Assurance in Research
• The contract stipulates that UNICEF owns all the intellectual property in the research collected or generated as part of the contract and does not give the contractor any right to use the research materials. In such cases, the Contractor can only issue an external academic publication with the prior written consent of UNICEF. (This consent would be from the Head of the relevant office/division, based on the advice of the relevant programme manager). UNICEF can veto the publication if it determines that it is appropriate to do so
• In some cases, UNICEF may have given the contractor the right to use the research generated as part of the contract for non-commercial academic or educational purposes. In such cases, UNICEF generally requires that the contractor share the proposed draft with UNICEF at least thirty days before sharing it with the third-party publisher to allow UNICEF (a) to ensure that no confidential information is included and (b) to provide comments. (This review would be done by the relevant programme manager, who should also notify the Head of the relevant office/division of the imminent publication).
• In the interests of transparency, the following items should ideally be prominently disclosed in all external academic publications: (a) the author’s role and relationship with UNICEF; (b) any actual or potential conflict of interest by the researchers; (c) all funding sources for the research.
• Appropriate attribution of the source of the research data should be included.

 

10.  Schedule of Tasks & Timeline

 

S. No.

Major Task

Deliverable

Specific delivery date/deadline for completion of deliverable

Estimated travel required for completion of deliverable

1.

Produce inception report which cover the methodology of entire research, objectives, data collection method, questionnaires, analysis and lastly timeline

Inception report approved by UNICEF and relevant government counterpart

Within 30 calendar days after signing of contract

As per requirement to complete this deliverable. All travel related cost should be included in financial proposal bid

2.

Organization of field teams and their training -

# Selection of teams           # Training & orientation of interviewers and supervisors

• Approval by IRB.

Within 45 calendar days after signing of contract

All travel related cost should be included in financial proposal bid

3.

Capacity development of service providers in Bhola M-SCANU and national sites

• Draft SOP and guideline on M-SCANU implementation developed
• Service providers of Bhola M-SCANU and SCANU are trained based on piloted SOP and guideline

Within 90 calendar days after signing of contract

 

4.

Produce progress report after data collection and analysis covering the initial findings of research.

This report must be submitted to UNICEF and to relevant government counterpart. In case of national level workshop for reviewing these findings, selected organization will act as main facilitators in workshop.

Progress report endorsed by UNICEF and relevant government counterpart

Within 90 calendar days and 180 calendar days after signing of contract

All travel related cost should be included in financial proposal bid

5

Produce final report comprised of overall findings, recommendation & economic evaluation.

This report must be submitted to UNICEF and to relevant government counterpart. In case of national level workshop for reviewing these findings, selected organization will act as main facilitators in workshop.

Final report endorsed by UNICEF and relevant government counterpart.

 

Within 250 calendar days after signing of contract

All travel related cost should be included in financial proposal bid

6

Current Policy Analysis, Gaps, Develop policy brief and presentation for advocacy.

Final policy brief document endorsed by UNICEF and relevant government counterpart.

Within 250 calendar days after signing of contract

 

7

Prepare a manuscript(s) for a peer-reviewed journal & Produce publications.

 

The following document will be endorsed by UNICEF and government:

# Manuscript for peer-review journal & Publication

Within 250 calendar days after signing of contract

 

8

Facilitate dissemination workshop

Dissemination workshop including UNICEF and relevant government & developing agency counterpart.

Within 270 calendar days after signing of contract

 

 

11.  Estimated duration of contract

 

The research plan to start from 1st Oct,2024 and aim to complete by 30th June,2025. The exact time and date can be flexible depending on contract signing. However, the total duration will be within 9 months.

12. Deliverables

The deliverables are same as mentioned in the above table (Section 10: Schedule of tasks and timeline)

Sample Table of Contents for an Inception Report (no more than 30 pages, plus annexes)

1. Title page
2. Table of contents
3. Acronyms
4. List of tables and figures
5. Executive summary         
6.  INTRODUCTION*
   1. Objective of the implementation research
   2.  Background and context
   3. Scope of the work
7. METHODOLOGY*
   1. Research criteria and questions
   2. Conceptual framework
   3. Sampling
   4. Data collection methods
   5. Analytical approaches
   6. Risks and potential limitations
   7. Ethics and UNEG Standards
8. PROGRAMME OF WORK*
   1. Phases of work
   2. Team composition and responsibilities
   3. Management and logistic support
   4. Calendar of work
9. ANNEXES
   1. Terms of reference of the IR*
   2.  Stakeholder map*
   3. Tentative outline of the main report*
   4. Interview checklists/protocols*
   5. Draft Study Tools*
   6. Theory of change / outcome model*
   7. Detailed work plan*
   8.  Detailed responsibilities of IR team members
   9.  Reference documents
   10.  Document map
   11.  Project list
   12.  Project mapping

 

Sample Table of Contents for a Final Report (not more than 60 pages, plus annexes)

• Title page
• Table of contents
• Acronyms
• List of tables and figures
• Executive summary           (with the purpose of the IR, brief methodology, key findings, conclusions and recommendations in priority order)

1. INTRODUCTION*

1.1. Background and context of intervention

1.2. Literature review

1.3. Objective of the evaluation

1.4. Scope of the evaluation

2. METHODOLOGY*

2.1. IR criteria and questions

2.2. Conceptual framework: Theory of change

2.3. IR design

2.4. Sampling design

2.5. Data collection methods

2.6. Analytical approaches

2.7. Risks and potential limitations

2.8. Ethics and UNEG Standards

3. FINDINGS*

3.1. Findings by criteria

3.2. Mixed method analysis (quantitative & qualitative)

4. POLICY IMPLICATIONS & RECOMMENDATIONS*

4.1. Recommendations, it will be explicitly linked to the findings and with the target audience identified.

4.2. Lessons learned.

5. ANNEXES

1. Terms of reference of the IR*

2. List of meetings attended*

3. List of persons interviewed*

4. List of documents reviewed*

5. Interview checklists/protocols

6. Study Tools

7. Any other relevant materials

 

*The structure of inception reports may be adjusted depending on the scope of the work. Chapters and sections with an asterisk should be included by default.

• It is advisable to outline the proposed structure of the inception and final report at this early stage, so that expectations are set accordingly. For the inception report, emphasize that draft study protocol and/or data collection tools are expected to be delivered.
• For evaluations, a note should be added that the length, structure and content of the final report will be as per UNICEF Evaluation Report Standards (GEROS), and that an Executive Summary is mandatory, which will be approved by an internal steering committee before the report can be finalized.

 

13. Team composition, Qualifications & Experience required:

This assignment will be undertaken by an agency that is primarily engaged in the conduct of research studies including extensive experience of conducting clinical surveys and qualitative research, and for this research especially in newborn and or child health related initiatives in the country.

The selected agency should have a successful track record of conducting high quality literature reviews, as well as designing, implementing, and analyzing both quantitative and qualitative surveys with a track record of at least five years of relevant activities in development, health, and significant experience within the government system especially on newborn health at community and facility level. The organization must have a substantial research infrastructure to support field-based data collection, capacity development in clinical service, electronic archiving of the data and capable of ensuring the highest level of confidentiality for research subjects as well as ensuring the validity of responses obtained.

Senior team members should:

• Hold a post-graduate degree in Newborn Health, master’s in public health or PhD in health, Social Sciences with specialist knowledge and experience of newborn health. Knowledge on gender equality including child rights is added benefit.
• Have clear understanding of clinical management of sick newborn, government health structure, processes and systems.
• Be familiar with the NNHP&IMCI program and SCANU program in the country.
• Have a minimum of 10 years’ experience, with preferably at least five years in the maternal, newborn and child health.
• Possess excellent verbal and written communication skills (English, Bengali)
• Possess excellent analytical, report writing and presentation skills.
• Be proficient in the use computer software. i.e., Windows 8, MS Office, Internet searches, including statistical data analysis software such as Stata or R.

Suggested composition of the expert team:

• A senior investigator (team leader); she/he should have the following: at least 10 years’ experience leading projects in the newborn/child health  field, including clinical capacity development of government staffs, operational research; experience in facilitating clinical service within government facilities, interdisciplinary work related to new initiatives and reviewing the existing system; track record of relevant research and scientific publications; at least 5 years project/program management and leadership experience; personal and team skills; experience with quantitative data packages; and good working knowledge of Bengali and English languages. Previous experience in maternal, child and newborn health programs is preferred. A track record of relevant research and scientific publications is required.
• A senior newborn health expert and statistician with the following: at least 10 years’ experience in quantitative research; experience in interdisciplinary work, including economic aspects; track record of relevant research and scientific publications; clinical management of newborn health; research management and leadership experience; personal and team skills; experience with quantitative data packages; and good working knowledge of Bangla and English languages. Previous experience in SCANU programs is preferred.
• A senior research field manager with the following: at least 5 years’ experience in leading field studies in the social sciences, in both qualitative and quantitative research; personal and team skills; experience with quantitative data packages; and good working knowledge of Bangla and English languages.

Enumerators must have the ability to interview respondents, facilitate and collect data in English, Bengali and other local languages and translate the research material. The enumerators should have at least two years of experience in field work, be fluent in the necessary local languages and must have completed a high school diploma.

14.  Duty Station

The organization will be based in Dhaka with frequent travel to sites. The potential sites of visit are SCANUs within Dhaka, Cox bazzar , and Bhola district, however subject to changes as per need.

15. Management and Supervision

1. The contracted research or evaluation agency will play a critical role in executing the activity with a clear set of responsibilities and expected standards. Primarily, the agency will be responsible for designing the study, implementation through government facilities, collecting data, and analysing the results. They will ensure rigorous adherence to quality assurance measures, such as the meticulous recording and reporting of any suspected adverse events. Further, the agency will monitor clinical services by government service providers, implement robust data handling and record-keeping protocols with quality check to maintain data integrity and confidentiality. Quality control will be integral to their processes, with regular audits and validations to ensure accuracy and reliability of the data collected. The agency will also be required to provide comprehensive, transparent reports and updates to keep all stakeholders informed and engaged throughout the study period. This combination of roles and responsibilities, along with stringent quality measures, will ensure that the research is conducted to the highest standards and yields actionable insights.

 

1. UNICEF: UNICEF will provide overall technical management for this research. The contracted agency will operate under the supervision of a health specialist, who will report to the health manager and, ultimately, to the Chief of Health. All materials, including reports, questionnaires, and other documents, must be certified by the health specialist before being finalized. The selected agency is required to share drafts of all materials and present them to government counterparts after receiving endorsement from UNICEF.

16.  Official Travel:

All travel related cost needs to include in the financial proposal. In line with UN procedure for contracted partner, only economy class travel is applicable, regardless of length of travel.

17.  Payment Schedule

• 1st payment (15%): upon acceptance of, IRB approval letter, onboarding of team member, finalized inception report (to be shown in inception report) (Deliverable-1-2)
• 2nd payment (20%):  upon finalization of 1st progress report including findings, as agreed with UNICEF (Deliverable-4)
• 3rd payment (20%):  upon finalization of 2nd progress report including findings, as agreed with UNICEF (Deliverable-4)
• 4th payment (30%): upon submission and acceptance of final report and policy brief, as agreed with UNICEF (Deliverable-5,6,7)
• 5th payment (15%): upon submission and acceptance of dissemination workshop and acceptance of all finalized deliverables and raw data (Deliverable-8)

 

 

 

18. IDENTIFICATION OF RISKS FOR THE CONSULTANCY AND PLAN FOR MITIGATION

Risks may be related to:

1. Environmental risk - the political environment, market environment or delivery infrastructure environment, among others.
2. Programme risk - the complexity associated with the nature of the service to be acquired, among others.
3. Implementation risk - risk associated with the capacity of the implementation unit/team.

 

Risk Identified

Mitigation measures

Environment Risk-

The political environment- The country is undergoing rapid changes, potentially leading to unrest such as roadblocks, protests, and civil disturbances during the implementation period.

UNICEF will collaborate closely with national and local security teams to safeguard the staff's safety and well-being involved in this initiative.

The selected organization will be responsible for the safety of its staff when traveling outside Dhaka and must promptly report any delays to UNICEF..

Program risk – the need to secure approval from the country's Ethical Board for the implementation research (IR).

The selected organization will be tasked with obtaining Institutional Review Board (IRB) approval for this research.

During the selection process, the organization's capacity to conduct IR and secure IRB clearance will be thoroughly evaluated.

Implementation Risk – Challenges in securing government endorsement for the initiation of IR, its reports, and policy briefs..

UNICEF will support relevant programs to host multiple workshops at national and sub-national levels.

Key stakeholders, including ADG, LD, PM, and technical experts in newborn health, will participate in these workshops to discuss methodology, timelines, and data collection of IR.

This approach aims to gain government buy-in from the onset, facilitating the endorsement process.