CONSULTANCY TO DEVELOP COMMUNITY HEALTH WORKER (CHW) TRAINING CURRICULUM

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CONSULTANCY TO DEVELOP COMMUNITY HEALTH WORKER (CHW) TRAINING CURRICULUM

TERMS OF REFERENCE

CONSULTANCY TO DEVELOP COMMUNITY HEALTH WORKER (CHW) TRAINING CURRICULUM

BACKGROUND INFORMATION:

Lwala Community Alliance (Lwala) is a community-led innovator proving that when communities lead, change is drastic and lasting. Lwala is leveraging this bottom-up approach in an all-out effort to drastically reduce maternal and child mortality; tackling the key drivers of deaths – unplanned pregnancies, mother-to-child transmission of HIV, poor prenatal care, unskilled deliveries, poor clinical practices, lack of emergency transport, and delayed treatment of childhood illnesses.

The program employs a community-facility approach, supporting clinical services at government health facilities and running a robust community health worker program. Key program outputs include:

  • Tracking and supporting every pregnant mother, child under 5, and person living with HIV
  • Increasing community access to and facilities for reproductive health, maternal, HIV, and child health services as a comprehensive package

This approach is yielding extreme health outcomes including facility deliveries increasing from 26% to 97%, rates of mother-to-child HIV transmission nearing zero, and a 300% increase in family planning uptake.

PURPOSE:

Lwala is recruiting a consultant to develop a generic CHW curriculum to be used as a blue print for health care organizations interested in implementing the Lwala Community Health Worker model in their existing programs or improving upon their current CHW program. Selected examples and case stories of Lwala’s CHW model will be referenced to help address the gaps in existing literature.

The consultant will also develop training materials and run a short training for the project team to ensure that they are able to effectively deliver the curriculum. The consultant will draw on Lwala’s existing CHW program guide, as well as best practice materials from other organizations.

RATIONALE:

Serving at the frontline of healthcare delivery, the experiences of CHWs are essential to informing evidence-based best practices with the potential to improve health outcomes for medically underserved populations. Numerous CHW models have been implemented across the world. However, there are very few evidence-based guides on the successful implementation of models that achieve better patient outcomes, higher quality of care, and lower health care costs.

Lwala Community Alliance started implementing the community health worker program in 2012 out of the belief that harnessing community’s resources was the surest way to addressing some of the most pressing health challenges in the region.  Part of these challenges was the high maternal and child mortality occasioned by low access to maternity care services.  In her truly community driven approach, Lwala turned to the hitherto condemned resource – traditional birth attendants to drive up uptake of maternity hospital.  From this humble initiative, a robust community health worker program has been developed that now supports over 30,000 people.

The community health workers are at the center of our success.   They support every pregnant woman in our catchment area, provides household water sanitation and hygiene education, monitors children from zero to five years, drives uptake of family planning services, provides community care and prevention of HIV and malaria treatment for under 5s and many more.  These efforts have drastically improved maternal and child health outcomes in the area. 97% of the women deliver under the care of a skilled attendant, infant and child mortality has dropped to half the county average while nearing zero in maternal deaths and mother to child transmission of HIV. We believe that with the right training, tools, supervision and compensation plans, community health workers can bring immense health dividends to people and governments.

Lwala has demonstrated that availability of maternal and child health services and a community linkage worker system that establishes intimacy and trust between community members and pregnant women can increase the proportion of women delivering in a facility and utilizing family planning. While the program was designed to address issues faced in North Kamagambo, barriers to maternal health services found there are similar to those often found in other rural areas. Potential exists for this program to be expanded to reach more women and families in the surrounding region and replicated in other communities in sub-Saharan Africa.

OBJECTIVES:

The objective and purpose of this consultancy is to develop a curriculum/training manual that can be used in training Community Health Workers as frontline health care providers. The training manual will codify practices in the current community health worker program while optimizing the service package that community health workers can deliver.  Specifically, this process aims to:

a)     Determine and structure the content of community health worker training package

b)     Develop key modules of a community health worker program

c)     Design training and delivery methods that can be used in delivering the content to community health workers

d)     Define the range of health services and skills for their delivery by community health workers in line with prevailing policies and regulations

e)     Build the capacity of community health workers to have the right knowledge, skills and attitudes to deliver healthcare effectively

f)      Define a supervision system that ensures quality in service delivery by community health workers

g)     Recommend appropriate technologies that can help manage and empower community health workers in the course of their work while easing reporting and documentation

h)     Provide materials including illustrations ready for typesetting and production in various formats

METHODLOGY:

Interested parties are requested to tender a short outline of methodology of how they would undertake the assignment, both on a theoretical and practical basis. This should include but not limited to:

a)     Review of existing curriculum or training manuals for community health workers in Africa identifying key themes across board

b)     Discussions with Community Health Workers to understand their current scope of services among others

c)     Curriculum design outlining the key content of the training manual and delivery methodology

d)     Collation of content and packaging into a coherent manual

e)     Validation with stakeholders to ensure acceptability across board

KEY DELIVERABLES:

The key deliverables are described below:

  1.  Inception report interpreting the ToR and including work plan with key milestones and deliverables.
  2. Outline of contents and materials
  3. Draft generic curriculum package and delivery methodologies
  4. Report of the validation meeting of the curriculum to be attended by relevant stakeholders
  5. The final curriculum package after incorporation of comments from validation meetings. The curriculum should be highly interactive and participatory, embrace use of technology, real-life situations, simulation etc., simplify the implementation strategies underpinning a number of highly effective CHWs models, support the establishment of dialogue on functional community health systems and potentially sets the stage for concrete policy    recommendations.
  6. A training of trainers to orient the program teams on the new curriculum
  7. Completion/ closeout report

TIMELINES: 

It is envisaged that the consultancy will require a total of approximately 30 days. A tentative timeline for this consultancy is presented below. This will be finalized with the consultant.

  OUTPUT DAYS DATE
1 ToR reviewed and agreed by consultant and Lwala.    
2 Consultant reviews resources and develops outline structure for the curriculum.    
3 Consultant develops draft curriculum and materials.    
4 Validation forum and review of feedback provided by stakeholders.    
5 Consultant develops final curriculum package and materials.    
6 Training for Lwala community health program teams.    
7 Completion report.    

 

QUALIFICATIONS:

Interested consultant(s) are advised to apply as individuals or as a multidisciplinary consortium with Capacities to support the development of the curriculum. In case of a consortium, the team must have a clear leadership structure, quality assurance and point of communication. The individuals/ team members of the consortium should have expertise in the following areas:

A:

  • Public health especially working with frontline health workers in last mile areas
  • Knowledge of community –led health delivery mechanisms
  • Extensive knowledge in the work of and models of community health worker programs
  • Proven experiences in developing curriculums/ training manuals for similar contexts

B:  At a minimum the individual consultant or consortium lead must possess the following:

  • At least a Masters Degree in Public Health, Community development or Social Sciences
  • At least 5 years demonstrated experience working on health programs
  • Good understanding of the community health worker cadre, Kenya community health strategy and prevailing policy
  • Good spoken and written communication skills in English
  • Proven experience of using participatory methodologies in training development
  • Excellent analytical and report writing skills
  • Of high ethical values
  • Ability to meet deadlines

COORDINATION AND SUPPORT MECHANISMS:

The consultant (s) will work closely with the Lwala Community Alliance under the leadership of the Policy and Partnerships Director. However, overall guidance and supervision of the work will be provided by the Leadership team.

SUBMISSION OF PROPOSALS: 

Interested consultants should submit a technical (not more than 5 pages) detailing response to the terms of reference and in particular the methodology for carrying out the assignment. The response should include proposed work plan, detailed CVs of lead consultant and co-consultants and a sample of work done on a similar or related task.  In addition, please provide a separate financial proposal (1 page).

The soft copies of proposals and other supporting documentation should be submitted to the Policy and Partnerships Director, hillary@lwalacommunityalliance.org. Due to the urgency of the position, applications will be reviewed on a rolling basis. For any clarifications, please contact the aforementioned with questions.

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