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Short Term Qualitative Research Consultant for the DGIS project in Kazakhstan

Country: Kazakhstan
Purpose: To conduct a qualitative survey for in-depth analysis on the involvement of the private sector in the provision of TB and HIV services

KNCV Tuberculosis Foundation

KNCV Tuberculosis Foundation is an international non-profit organization dedicated to the fight against tuberculosis (TB), still the second most deadly infectious disease in the world. KNCV is an international center of expertise for TB control that promotes effective, efficient, innovative and sustainable tuberculosis control strategies in a national and international context. We are an organization of passionate TB professionals, including doctors, researchers, training experts, nurses and epidemiologists. We aim to stop the spread of the worldwide epidemic of TB and to prevent the further spread of drug-resistant TB. Over the past century we have built up a wealth of knowledge and expertise, initially by successfully controlling TB in the Netherlands. Since the 1970s, we have also shared our knowledge and expertise with the rest of the world. We operate from a central office in The Hague in the Netherlands, a regional office in Central Asia and country offices worldwide. KNCV raises funds from private, institutional, corporate, and government donors.

DGIS Project

KNCV is the lead partner in a five year project funded by the Netherlands Ministry for Foreign Affairs (DGIS). The project’s aim is to strengthen Global Fund grants addressing TB/HIV programs in selected countries—“making Global Fund money work”. Specifically, the project’s main goal is increasing and maintaining Global Fund performance and strengthening the base for a sustained country response. The DGIS project is implemented with the support of a partnership of three Dutch NGOs; AIDS Foundation East West, HIVOS and PharmAccess. This project is also integrated with Challenge TB, a major USAID supported project lead by KNCV and in particular with its Global Fund Hub.
The DGIS project is built on three main pillars:

  1. Pillar 1: Improve TB and TB/HIV case finding and treatment success by strengthening engagement of the non-public sector.
  2. Pillar 2: Improve Global Fund implementation through quality long term technical assistance.
  3. Pillar 3: Shape TB and TB/HIV policies at the Global Fund Board.

Background of the Short Term Technical Assistance

This STTA is being requested to support the DGIS project’s Pillar I activities in Kazakhstan (see above for Pillar I description). In July-August 2015, KNCV conducted a preliminary analysis of the current provision of TB and HIV care by both the both the public and the non-public health sectors in Almaty city, in the Republic of Kazakhstan. The analysis showed that – next to public providers – private clinics are also involved in TB detection and treatment of TB patients and PLHIV. In order to get more insight of the current involvement of the private providers in TB and TB/HIV detection and treatment services in Kazakhstan and their possible future areas of engagement in TB and TB/HIV care, KNCV requests the services of a consultant to conduct an in-depth analysis survey. The results of the analysis will be used for defining a strategy on engagement of the private sector in TB and HIV services in Kazakhstan.

Methodology and objectives

The qualitative survey, conducted in 5 – 6 private clinics based on the following selection criteria:
Taking into consideration the fact that according to the national regulations private clinics are allowed now to provide standard general medical care guaranteed and funded by the government to the populations living in a specific administrative territory, those private clinics take responsibility to provide general medical care that also includes screening and diagnosis on TB. Those clinics also become accountable to the local healthcare department as they are involved in provision of the state’ basic standard general medical care.

Therefore, selection of private clinics will be based on the following criteria:

  1. private clinics that provide general medical care, i.e. participate in the state health care program.
  2. private clinics that offering screening programs that usually includes X-ray examination.
  3. private clinics that receive migrate populations due to their location (close to the bus stations, train stations)

In selected private clinics, the local consultant shall conduct interviews with the following staff members: 1) manager; 2) epidemiologist; 3) therapist; 4) min 2 doctors, max 5 doctors. In total about 6-7 specialists will be interviewed in each clinic.

The main research questions are:

  • What is the referral system used in case of identification of presumptive TB cases?
  • Do they record and report information about cases of presumptive TB and confirmed TB? If so, to which body and through what mechanism?
  • If the legal framework were to allow the provision of TB and TB/HIV detection and treatment among the private sector, what is the best way to engage private providers in TB services, and in which specific TB services?

Scope of work:

Preparation for analysis:

  • Finalization of a survey tool and questionnaire drafted in April 2016.
  • Identify the 5-6 private clinics to be included in the analysis based on the selection criteria/methodology.
  • Development of database template
  • Interviews, data collection and data entry
  • Conduct interviews with 6-7 employees (minimum 2, maximum 5 general physicians + 1 director / deputy director for clinical work / epidemiologist (if available in the clinic)) using a questionnaire developed in selected private clinics in the Almaty city.
  • Cleaning data.
  • Data analysis and report writing
  • Develop a full report with the survey findings on private provider’s: a) current practices and b) interest to become engaged in TB and HIV services, and recommendations on how to strengthen the engagement of the private sector.

Deliverables
Report on the results of analysis

Timeframe
The scope of work shall be conducted in the period mid-June – end of July 2016, not exceeding 22 days (including preparation and report writing). A local consultant is requested to perform work in the period as mentioned above.

Expertise Required

  • Education in medicine or public health
  • Understanding of the health system and the role of the private sector in Kazakhstan.
  • Knowledge and understanding of the TB/TB-HIV epidemiology in Kazakhstan, structure of TB and HIV and the TB and HIV legislation framework.
  • Research experience in the field of TB, HIV and health systems
  • Ability and experience in interviewing medical professionals
  • Strong analytical and writing skills
  • Fluent in Russian and Kazakh languages (English is desired)

Application and information
Your application (Curriculum Vitae, proof of prior experience and proficiency in the stated assignment) should be sent before 10 June to: Svetlana Pak, email svetlana.pak@kncvtbc.org, under subject “Short Term Qualitative Research Consultant for the DGIS project in Kazakhstan”
For further information about KNCV Tuberculosis Foundation, please see www.kncvtbc.org