STC- Preparation for development of eHealth Strategy, including scoping of ICT needs for primary care and provincial hospitals in Cambodia

BACKGROUND

Countries in the Western Pacific Region are at different stages of eHealth development. In some countries, collection and use of digital/electronic health information through electronic systems is well-advanced; in others it is just beginning. Common challenges are for example inadequate or fragmented information and communications technology (ICT) infrastructure or a lack of well-trained human resources for health information systems. However, regardless of where countries or territories are in their health information system implementation, they can strengthen their health systems based on a well-designed eHealth strategy. Furthermore, the successful implementation of eHealth strategies and the realization of their benefits rely on strategies and solutions that are well aligned with the government’s priorities, local needs and conditions.

Cambodia

In 2005 the World Health Assembly encouraged development of “eHealth strategies” (WHA58.28 2005). In 2018, the 69th session of the World Health Organization Regional Committee for the Western Pacific, Member States endorsed the Regional Action Agenda on Harnessing eHealth for Improved Health Service Delivery, and agreed to develop or strengthen national e-health strategies, in line with national health priorities and cost and resource considerations (WPR/RC69.R2).

Cambodia’s need for a comprehensive eHealth strategy has been recognized both by local stakeholders and donor partners. The Health Information System Strategic Plan (HISSP), 2008–2015 for Cambodia was concerned with i) HIS policy and resources, ii) data management and use, iii) health and disease records including surveillance, iv) census, civil registration, and population based surveys, and v) health service administration and support systems, and provides a foundation for the growth of an eHealth strategy which builds on and extends to support with a modern ICT infrastructure the new strategic priorities that as they emerge for the health system in Cambodia. With the growing healthcare needs and in turn, the need for more efficient healthcare interventions, Cambodia would benefit from a new strategy to guide the development of eHealth in the country.

Significant investments in health information have been made in Cambodia. This includes the introduction of the HIS web based database system allows health employees at HC, Referral Hospital and OD level to enter HIS monthly data directly into the system with all health staff able to access the HIS data only minutes after the data being entered. In addition, there are now moves toward patient-level recording with a Patient Management and Registration System (PMRS) which produces a computerized individual unique ID and enables separate visits to be linked. The hosting of HIS and PMRS in a secure cloud-based environment has taken time to achieve, but as the costs, benefits and risks become increasingly acceptable and this is laying the basis for sound information systems to support Health Equity funds, and increase access to health services in particular for the poorest. In this way, information systems have an important contribution to make to improving equity in service coverage as parts of efforts towards universal health coverage.

A further achievement in Cambodia is the rapid deployment of new technology. The spread of 3G, and increasingly 4G, communications will mean that mobile broadband based services will become available everywhere, and use of increasingly affordable smart phones and tablets can be expected to become widespread over the next 5 years or so. Some innovative use of SMS, collaborative apps, and Interactive Voice Recognition technologies, for example, have already been deployed in projects that are ready to be taken to scale.

These investments included planned implementation of other stand-alone applications without a national plan or a way to integrate these disparate systems, the acquisition and deployment of equipment that may not be architecturally suitable, and the unlinked capacity building programs across the health sector in general. To date little efforts have been made to ensure alignment of eHealth investments and activities. This consequently run the high risks of a fragmented and siloed system fraught with user dysfunctionality and interoperability challenges making eHealth in Cambodia unscalable and unsustainable in the foreseeable future. The broadening of understanding of the ways in which ICT can be used to support (and indeed in some respects transform) the organisation and delivery of health care is what a vision for a National eHealth strategy will establish. And the associated actions will clarify what needs to be funded and done so that applications and services are delivered that are of benefit to managers, clinicians and patients.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

The WHO Country office and the Ministry of Health in Cambodia require a specialist in Health Information Systems and Health Informatics to scope information and communications technology (ICT) requirements at primary care level and provincial hospitals, and prepare for the development of the Cambodia eHealth strategy.

Working closely with the Government of Cambodia, and the WHO Country office and WHO Regional Office for the Western Pacific, the contractor will contribute to planning, developing and strengthening eHealth (with consideration of the HISSP and Health Strategic Plan 2016-2020) in Cambodia in a scalable and sustainable manner. The purpose of the contract is to:

1.            Scope current resources and initiatives in Cambodia, in particular at primary care level and provincial hospitals in 3 Operational Districts, to implement eHealth initiatives, and assess needs and potential models to facilitate the use of electronic medical records and deployment of a unique identifier for patients.

2.            Prepare for the development of the Cambodia eHealth Strategy, undertaking initial consultations with key stakeholders, identifying key areas to be covered and existing resources, and preparing a workplan and timeline for development of the Strategy. This preparation should consider any existing electronic medical record systems being trialled in the country.

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

Output/s

Detailed scope of work includes but is not limited to supporting:

Activity  1: Scoping of ICT needs in health facilities in three operational districts

Objectives and deliverables

•To outline current resources for eHealth initiatives in health facilities in these three operational districts (ODs).

•To provide overview of models available in country to address ICT needs.

•To define needs in these three ODs and potential model to address ICT and eHealth needs.

•Key deliverable: A report describing current resources, needs and opportunities for ICT at primary care and provincial hospitals in the three ODs, including recommendations and implications for development of the Cambodia eHealth Strategy.

Activity 2: Preparation of workplan and timeline for development of Cambodia eHealth Strategy

Objectives and deliverables

• To conduct initial consultations with key stakeholders in eHealth in Cambodia.
• To prepare overview of current resources, policy initiatives and models for eHealth in Cambodia.
• To submit a workplan and timeline for development of Cambodia eHealth Strategy
• Key deliverable: An inception report for the Cambodia eHealth Strategy, outlining current status, key policy context and documents, key objectives, workplan and timeline for development.

METHODS TO CARRY OUT THE ACTIVITY

Desk study and in country support

• Conduct consultation with other partner agencies and the government counterparts in the inception phase to coordinate the work to avoid duplications and support existing work efforts. If required, the scope of work needs to be adjusted accordingly.
• Conduct consultation workshops with respective stakeholders in the country such as Ministry of Health (including the Department of Health Planning and Information), major health donors and partners, e-Government stakeholders, NGOs, education oriented organisations, other government departments, private sector, ICT suppliers, civil society groups and hospitals, academia and public health.
• Conduct key informant interviews with front line health workers and with hospital staff, as part of field visits to health facilities in three operational districts.

Conduct final workshop to present the different options, their benefits and costs with all relevant stakeholders and support the decision-making process for moving forward on the development of the Cambodia eHealth strategy

QUALIFICATIONS & EXPERIENCE 

The requirements for this consultancy are as follows:
Education required: Master degree(s) in public health, health management information systems/health informatics, ICT, or health economics

Experience required: At least 7 years of work experience in health informatics and/ or health information systems. Work experience on digital health/eHealth strategies, and in Cambodia or other low- and middle-income countries is an asset. 

Skills / Technical skills and knowledge: The contractor understands health ICT governance, and standards based health enterprise architecture. Understanding of eHealth for integrated health services delivery is an asset.

Language requirements:      

Written and spoken fluency in English is essential.

COMPETENCIES

• Communicating in a credible and effective way;
• Producing results;
• Moving forward in a changing environment; and
• Fostering integration and teamwork.

ADDITIONAL INFORMATION:

DUTY STATION: Phnom Penh, Cambodia
ORGANIZATION:  WHO Western Pacific Regional Office
TYPE OF CONTRACT: Short Term Consultant
APPLICATION DEADLINE:  11 February 2019
STARTING DATE:  February 2019
DURATION OF CONTRACT: 8 Weeks

Expressions of interest should provide a daily rate in US$.

APPLICATIONS

Qualified and interested specialists should submit their CV and Expression of Interest {cover letter} and proposed daily and monthly rate in USD to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 11 February 2019. Only individual contractors will be considered.

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and availability.

Please use Tender Notice No. WPRO/2019-01/KHM_HSD/TN83096/vrs  as subject to all submission.  Only successful candidates will be contacted.