Background

Coalition PLUS is an international union of community-based organizations involved in the fight against AIDS and viral hepatitis. Founded in 2008, Coalition PLUS partnerships encompass nearly 100 civil society organizations present in 40 countries. In line with the community-based approach, our coalition advocates for people who are infected, affected or particularly vulnerable to HIV or HCV to be systematically involved in the decision-making process, implementation and evaluation of relevant health interventions. Through the various programs led by its Secretariat and its 6 sub-regional intervention platforms, Coalition PLUS aims at strengthening its members’ and partners’ capacities and expertise. Since 2015, Coalition PLUS has coordinated the HCV/HIV Drug Affordability Project, an initiative comprising 9 civil society project partners acting in 5 countries—Brazil, Colombia, India, Malaysia, and Morocco. The project seeks to increase the number of individuals accessing HCV medicines—with a particular emphasis on co-infected populations—through campaigns targeting awareness, diagnostics and treatment.

This project takes place in a global health space in which WHO member nations agreed to a first Global Hepatitis Strategy. This strategy, agreed in 2016, included member states’ commitment to the goal of HCV elimination by 2030, as well as shorter-term targets for 2020. The recent emergence of highly effective direct-acting antivirals has proved a catalyst to the acceleration of responses to HCV, leading to the development of more aggressive national action plans and the updating of country-level guidelines.  

Yet as 2020 approaches, most of the global progress toward the WHO’s 2020 targets for diagnostic and treatment may be primarily attributed to high rates of diagnosis and treatment in high-income countries. While many low-to-middle income countries (LMIC) governments have indeed stepped up their response, few—if any—are on course to reach the 2020 targets, let alone targets for 2030. In response, Coalition PLUS France and its project partners carried out an exploratory study in 2018. Summarized in a report named Mind the Gap, the study aimed to provide an evaluation of the barriers to access to HCV services among most-at-risk populations [defined as persons who inject drugs (PWID), ex-PWID, and persons living with HIV (PLHIV)]. The study identified insufficient awareness and insufficient service capacity as major system-level obstacles to successful scale up HCV responses across the survey countries; at the level of at-risk populations, the study identified that at-risk individuals often found the service pathway to be too long, too complex, and too costly. In its conclusions, the report called for greater decentralization of HCV services, the simplification of the HCV service pathway, and the integration of HCV services into packages of care addressing marginalized populations. The initial study was carried out in Thailand, Indonesia, India, Malaysia, and Morocco. The second iteration of the study seeks to build on the first in several key areas: by evaluating ground-level progress in policy implementation over the period since the first study; by expanding the number and geographic scope of sites involved in the study; and finally, by identifying the service-related needs expressed by at-risk populations. The general protocol for the study will be provided by Coalition PLUS France. The national consultant will work closely with Coalition PLUS’s in-country project partners, who are either community-based organizations themselves or work closely with community-based organizations. Coalition PLUS in-country project partners will be able to provide modest contributions to facilitating outreach to community members and may be able to provide support on days of survey implementation (extent to be confirmed with in-country project partners). However, the national consultant will be the lead coordinator and implementer of the study; the national consultant will also be responsible for ensuring all data collection, analysis and write-ups of study findings/recommendations.

For reference, Coalition PLUS France refers to the HIV/HCV Drug Affordability Project team in Paris (i.e. policy officer and project manager) and the Coalition PLUS Community-Based Research Laboratory (i.e. Laboratory manager and director). Coalition PLUS in-country project partners refer to in-country partners involved in the Coalition PLUS HIV/HCV Drug Affordability Project (see table below).

In-country project partners:

Malaysia Malaysian AIDS Council
MTAAG+
Morocco ALCS
Brazil FOAESP
Colombia Fundacion Ifarma
India Delhi: DNP+
Manipur: CoNE

Description of Study and National Consultant’s Role

Coalition PLUS is seeking a national consultant to coordinate implementation of a mixed methods community-based research study on the state of the HCV response for each country in its project scope (i.e. one consultant per country, India being an exception). The study will evaluate access of most-at-risk populations to HCV services, as well as the reasons for failure/success in accessing these services and the identification of possible HCV care needs. A final report will provide recommendations in accordance with national findings.

The study methodology will be broken into two parts:

  1. A survey of at-risk populations on issues related to barriers to HCV services and their HCV health service needs. The survey will be administered via verbal interviews (i.e. survey administered orally to participant and noted by survey administrator; note: to be determined, but survey administrator may also include some staff of in-country project partners); the targeted duration of each survey will be a maximum of 15 minutes. The number of participants in the study will be agreed by both parties (Coalition PLUS France and national consultant) by XXXX (date to be determined), in advance of finalization of the consultant contract. Following the survey, the data will be cleaned, synthesized and analyzed. The results of this survey will inform the second part of the study, which will involve focus groups
  2. Three focus groups discussions will be conducted (number of persons to be determined). The focus group discussions will explore many of the survey questions in greater depth, using the survey findings to elaborate the understanding of context behind the survey results.

The general protocols for the survey and focus group discussions will be developed by Coalition PLUS France and in-country project partners and provided to the national consultant.

The national consultant’s tasks will include:

  1. Liaisoning with Coalition PLUS France in understanding study objectives and study protocol and with Coalition PLUS in-country project partners to understand the in-country context of the HCV response
  2. Liaisoning with Coalition PLUS in-country project partner for selection of study sites, local study coordination, implementation and interpretation of study data;
  3. Lead in completing dossier for ethical approval and submitting applications in implementation country;
  4. Regular Skype exchanges with point person at Coalition PLUS France and representative of in-country project partner (average once per week, 30-60 minutes)
  5. Collection of informed consent from all study participants.
  6. Leading implementation of a survey of XXXX participants over X number of sites (exact number of participants / sites to be determined based on protocol completion; for purposes of candidate’s proposal, please refer to number listed below of 250 participants across 6 sites); this includes:
    • The national consultant will work with the Coalition PLUS in-country project partner to translate the questionnaires and identify the survey implementation sites. If a limited number of staff from Coalition PLUS in-country project partners are able to support survey delivery on survey days, the national consultant will ensure proper training of that staff and oversight of their engagement in survey execution process. The national consultant will also be responsible for the collection of data and entering of data into online formulary (e.g. Survey Monkey). Collected data will be analyzed and summarized by the national consultant.
  7. Conducting three focus group discussions (conducted in local language) of roughly 1 hour each; ensuring the recording of focus group discussions, followed by intelligent verbatim transcription, and subsequent thematic analysis that involves identification of notable quotes (translated into English) and the drafting of a report of focus groups by thematic analysis.
  8. The implementation of the study may involve some travel. The national consultant should be able to travel domestically between 5-10 days during the consultancy.
  9. Sorting, cleaning, analyzing and collating information collected from the surveys, interpreting key findings of the focus group discussions, and recommendations;
  10. Writing of a synthesizing chapter that assembles all data from the surveys, key findings of the surveys, key findings of the focus group discussions, and recommendations in accordance to a report format provided by Coalition PLUS France. Coalition PLUS France will provide a blueprint for the structure of the chapter, while in-country project partners will be involved in the elaboration and validation of the recommendations.

The national consultant in each country will be responsible for implementing the national surveys, based on the methodology and tools provided by Coalition PLUS France. The national consultant commits to carrying out the surveys within the timeframe agreed. Information, updates, and study reports shall be provided to Coalition PLUS France in English exclusively and original study documents should be archived digitally (and ultimately shared with Coalition PLUS).

Consultancy Duration

The bulk of the period of the assignment would take place between December 2019 and April 2020, though the consultant may be asked to dedicate a limited number of days before or after that period. Payments will be released upon approval of the required deliverables and a detailed time sheet.

Deliverables

  1. Implementation program (study sites chosen, reasoning for these sites and expected participant number, focus group discussion plans) and timeline
  2. Successful submission of ethics committee dossier 
  3. Data collection, synthesis, analysis from surveys
  4. Focus group discussion reports
  5. First draft of full report in accordance to a report template (of findings and recommendations) provided by Coalition PLUS France
  6. Final draft of chapter in accordance to a synthesis form provided by Coalition PLUS France

Qualifications of the Consultant

A qualified consultant should have:

  1. Minimum 2 years (ideal of 5 years) relevant experience in qualitative and quantitative research projects. Interest, experience, and/or academic training in hepatitis, HIV, public health, human rights, international development, or related field is a plus;
  2. Advanced University Degree in social sciences (if applicable, members of the research team must hold University Degree in social sciences);
  3. Ability to develop, implement, lead, conduct focus groups and analyze corresponding data;
  4. Ability to develop, implement and conduct quantitative data collection and perform descriptive analysis;
  5. Experience in planning and coordination among various stakeholders;
  6. Experience working with communities of key populations and/or marginalized populations (e.g. people who inject drugs, men-who-have-sex-with men, sex workers, people living with HIV);
  7. Strong English writing skills;
  8. Fluency in English; local language mother tongue;
  9. Experience in community-based research is a plus.

To Apply:

Send Proposal/Expression of Interest, including the consultant(s) Curriculum Vitae, sample of prior work, and proposed consultant rate (per day) / time (days per step of consultancy execution) to complete consultancy during the specified timeline (NO phone calls please):

Information should be emailed to [email protected]lus.org with the subject line “National HCV Study Consultant – Application: Your Name + Country” by November 1st, 2019.

Candidates are expected to submit a proposal/expression of interest based on these Terms of Reference. The proposal should outline the workstream steps and the corresponding time for each step (in days); page 6 provides some guidance on elaborating workstream steps. Please note as well your current city of residence. For purposes of the proposal, please assume that the survey will be carried out in a sample of 250 people across 6 sites (i.e. roughly 50 persons per site). Please assume that 3 sites will involve travel to another location requiring overnight accommodation.  Also, for purposes of the proposal, assume the three focus group discussions will last one hour each and will be comprised of eight individuals per focus group. Finally, we ask candidates to please make note of any experience working with key populations, notably people living with HIV and people who inject drugs. Furthermore, if the national consultant intends to work in collaboration with another colleague to execute the consultancy, the CV of the collaborator(s) must be included in the proposal and noted accordingly in the budget.

The proposal/expression of interest will be evaluated against 3 main criteria:

(1) Quality of the proposal

(2) Relevant experience in similar type of research of the applicant;

(3) Budget for execution of the consultancy (including travel costs); feel free to elaborate assumptions made to generate the budget. Note: budget should NOT include the costs associated with compensation of study participants or in-country project staff

The proposal will be evaluated and ultimately selected by Coalition PLUS France. In-country partners will be consulted in the decision process.

Basic outline of consultancy steps:

Below is an initial estimation of key steps in the completion of the study. Please provide elaboration on key elements involved in each step, as well as the corresponding time to complete each step. Feel free to add comments on factors that will shape time for each step and to highlight questions/information you may identify as pertinent for executing each step. The purpose is to evaluate your understanding of key elements associated with performing the scope of tasks and the workload implication.  As noted above, we understand that the number of days will fluctuate according to number of participants targeted in the survey and the number of sites:

  1. Protocol training
  2. Preparation and submission of ethical review dossier
  3. Planning of schedule
  4. Planning of implementation
  5. Regular weekly exchanges with Coalition PLUS
  6. Survey implementation (includes entering of data notes on site)
  7. Keeping track of progress in central tableau (tableau provided by Coalition PLUS France)
  8. Focus group discussion preparation
  9. Focus Group Discussion
  10. Synthesizing, cleaning and analysis of data
  11. Drafting of report and follow up