International consultant for comprehensive assessment on Digital Health Management Information Systems (DHMIS

Contract

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Background

UNDP partners with the Global Fund to support and strengthen national responses to HIV, Tuberculosis and malaria. The objective is to ensure access to quality health services for all and enable all those living or affected by the diseases to live healthy, productive lives. The partnership leverages UNDP’s mandate to strengthened institutions to deliver universal access to basic services and rebuilding resilient health services in crisis and post-crisis settings.

UNDP is currently serving as the Global Fund’s Interim Principal Recipient (PR) in Tajikistan administering its HIV grant. Under the HIV grant, resources have been earmarked to support the expansion and development of its Health Management Information System (HMIS). The MOH and UNDP plan to establish a robust national digital HMIS to collect different types of health information from service delivery points at all levels to be used as evidence for decision making aimed at improving health care delivery.

The Ministry of Health’s goal is to implement its digital HMIS (DHIMS) nationwide by 2030. Currently, most health facilities, primary health care (PHC) polyclinics and hospitals use paper-based medical records for specific diseases and other health related data.The cumulative data is collected locally and transmitted or transferred from paper to the electronic DHIS2 online- and offline in some districts- merged, analyzed, by statistics departments of each oblast and and reported upwards to the MoH.

To effectively manage health care provision, the MOH plans to establish a more robust HMIS with the ability to collect and collate different types of health information from service delivery points. The MOH foresees that a fully operational DHMIS will provide integrated data collection and analysis from all levels of health care, allow information exchange and evidence-based decision making at all levels starting from where data are generated (health facilities) to the management level. This operationalization will also facilitate carrying out data quality checks using validation rules that can be established and applied regularly to clean the data.

The fully functional DHMIS, will provide information and data in a timely manner and will allow for more efficient management and decision-making for Government officials as well as other partners in the health sector. To facilitate this function, the MOH will need a platform to help integrate all necessary data for the purposes of routine management of the health sector, periodic policy review and redesign of health sector strategies and strategic management review, development, and revision of strategic and implementation plans. It will also ensure synergies with the electronic civil registration system and will address potential inconsistencies.

Since 2010, various international agencies have been supporting the MoH by introducing a sustainable health information system. Progress has been achieved through the pilot project "Automatization of polyclinics and hospitals of the Republic of Tajikistan" and the initiation of a national medical information system at the PHC level, carried out at the Dushanbe city health department between 2015 and 2018. Further, through EU support, a District Health Information System 2 (DHIS2) was piloted and implemented as an open source, web-based health management information system in-line with the MoH’s goal of implementing a nationwide Digital HMIS by 2030. This system has been used as a national districts health information system in all 67 districts for data management and analysis, health programme monitoring and evaluation, human resources and service availability mapping for logistics management. The World Bank also supported 439 rural health centers and health posts in 10 districts to establish a separate software program for collection of a set of specific health information in these districts. However, this software is not connected to the current national system and functions as a standalone system.

Key Tajik experts and staff have also been trained by the regional Health Information Systems Programme at the University of Oslo (HISP-UiO) in India, Moldova and Norway on how to conduct DHIS2 analytics, system configuration, and even advanced application development.Since 2017, the Tajik MoH has had full ownership of the DHIS2 platform including the application and data generated. In collaboration with experts in the DHIS2 community, the MoH has configured their own information system, building on the generic platform which included trainings on how to use modular, layered architecture with a strong and open application programming interface (API). This means that local experts learned to use and operate the capacities of the DHIS2 which essentially serve as a data warehouse with more than 60 native applications. The applications pull, or push data stored in the warehouse to perform different functions such as data quality checks or making scorecards.

The current DHIS2 in Tajikistan has been greatly advanced and developed over recent years however, many gaps remain in the current system which require further development and enhancement in many key areas. In many cases, there are still paper-based Health Information Systems (HIS) in use and health facilities and most hospitals continue to use paper-based medical records. The paper-based medical records affect the quality of reporting. The paper-based medical records limitat appropriate analysis of information, and requires additional time and resources to convert the data into electronic form. Furthermore, the current system lacks individual level patient data and the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan has highly prioritized the establishment and implementation of an individual electronic health record (EHR) system in several pilot cities and districts, which will be gradually rolled out throughout the country. All existing electronic health databases including those for TB and HIV programmes’ are planned to be integrated into the National individual Electronic Health Information Record (EHIR) and will be connected to the existing DHIS2.

In recognition of the importace of a robust national health information system in the of strengthening health sytems, UNDP in collaboration with MoH, seeks to recruit a technical expert(s), with significant experience to conduct a more comprehensive assessment of the situation and, building on the current DHIS2, to assist with the designing of a comprehensive and functional National Digital Health Management Information System (DHMIS) for Tajikistan.

Duties and Responsibilities

General Responsibilities:

The primary responsibility of the consultant will be to conduct a comprehensive assessment of the current District Health Information System, design technical specifications for fully functional Digital Health Management Information System (DHMIS) incorporating the individual EHR system and linked to existing electronic health data bases.

In addition, the consultant will also assist MoH to work closely with relevant stakeholders on all technical matters. This assignment will lead to a next phase which entails the full development of the DHMIS tool and capacity strengthening of relevant stakeholders for full national implementation.

Specific Tasks and Responsibilities:

Task 1: Comprehensive assessment of the current District Health Information System (DHIS2)

Conduct comprehensive mapping of current system and available technical and human resource capacities. Assess existing capacity of the system at national , regional and district level medical facilities and partner organizations, including a full stakeholder analysis.

Assessment of other existing electronic systems (HIV and TB), and how they interact with DHIS2,considering needs for interoperability between electronic systems.

Review and update DHIS2 tools and registers and DHIS2 training materials.

Review current data flow processes and user requirements for the new DHIS.

Map business processes behind data collection, to identify points for optimization

Identify gaps within the existing system, analyze optimum methods for improvement and propose recommendations and entry points for transitioning from DHIS to DHMIS.

Task 2: Design technical specifications for Digital Health Management Information System (DHMIS)

Identify and define the best technical solution for the DHMIS platform based on current DHIS2 system ensuring all required data at all levels of health care is captured. Furthermore, the platform will ensure integration with existing TB, HIV, DHIS2 electronic data collection systems while maintaining close cooperation with the partners responsible for the mentioned platforms, ( this will include engaging in discussions on the possible methods and requirements of integration with the propsed DHMIS)

Ensure that the developed technical specifications deliver all key MoH requirements for an efficient DHMIS (e.g. ensuring the new system is interoperable with the civil registration system (and other electronic monitoring systems) and also allows for the incorporation of automated reporting modules and dashboards)

Consider technical requirements for interoperability with existing electronic systems .

Develop the technical specifications for the needed EMR software.

The Consultant shall report to UNDP/HIV Prevention Programme Manager. The work will be facilitated in close coordination with the WHO Regional Office, and GF HIST team in Geneva;

For this IC contract the lump sum approach will be used where the payments are made in installments upon provision of the deliverables / outputs specified above;

The Consultant will be responsible for providing her/his own working station (i.e. laptop, internet, phone, scanner/printer, etc.) and should have access to a reliable internet connection during performance of the assignment;

The reports should include the detailed information about the activities performed during the assignment, the consultancy action plan along with its timing, any bottlenecks and gaps revealed as well as recommended remedial actions for their solution, the results of the assessment and analytical work performed as per ToR, the required materials and documents to be developed as per ToR;

The acceptability of reports will be judged by three criteria: (1) fulfillment of the assignment objectives as set forth in the contract/ToR, (2) adequacy of documentation, and (3) clarity of presentation. All reports must be submitted electronically, in MS Word. The language of the reports should be English;

The reports are to be reviewed and approved within 5 business days by UNDP;

The Consultant should ensure confidentiality of the information revealed during performance of the contract which is for UNDP use only and should be not disclosed without UNDP written agreement.

Payments will be made upon submission of the reports in accordance with payment schedule above and certification of the payment form, and acceptance and confirmation by the Supervisor on satisfactory delivery of outputs.

Travel:

No travel is envisaged under this assignment. All work shall be done distantly with support of a national consultant (data collection, facilitation at the country level, etc.) to be separately recruited by UNDP

Competencies

Corporate Competencies:

• Demonstrates integrity by modelling the UN’s values and ethical standards;
• Promotes the vision, mission, and strategic goals of UNDP;
• Displays cultural, gender, religion, race, nationality and age sensitivity and adaptability;
• Treats all people fairly without favouritism;
• Fulfils all obligations to gender sensitivity and zero tolerance for sexual harassment.

Required Skills and Experience

I. Academic Qualifications:

• Master’s Degree (minimum) in Public Health with a specialization on Economy of Health, Health Informatics, Community Medicine or Epidemiology. A Diploma in IT or computer and statistic is added value.
• Degree from University of Oslo (HISP-UiO) is an asset.

II. Years of experience:

• 10 years progressive experience as a public health practitioner;
• At least 5 years of work experience of the DHIS2 and analysis preferably at the same position in another country/DHMIS/ and professional experience in the administration of health information and the use of health data for strategic planning and management.
• Specific experience in open source application, server management, troubleshooting data flow issues, software (EMR/EHR) and database would be desirable.
• Previous experience conducting training on DHIS2 and EMR.
• Understanding of the structure and function of the Public Health System in Tajikistan will be an added advantage

III. Competencies:

• Language Abilities: Excellent knowledge of English and Russian with proven spoken and writing skills.
• Knowledge of Tajik will be considered an asset.

Application Procedure:

Please follow the link to download Individual Consultant Procurement Notice and follow the application procedures indicated in the downloaded ICPN:

http://www.undp.tj/va/upload/va/ICPN_HMIS%20International%20Consultant.pdf

UNDP is committed to achieving workforce diversity in terms of gender, nationality and culture. Individuals from minority groups, indigenous groups and persons with disabilities are equally encouraged to apply. All applications will be treated with the strictest confidence.