SPECIFIC TERMS OF REFERENCE
End of project Evaluation of the "Development of a Health Management Information System in Tajikistan" (HIS II) and Support to the EU Delegation to develop TOR for HIS Phase IH
FWC BENEFICIARIES 2011 - LOT 8: Health Request No DCI-ASTE/2011/270-005
1. BACKGROUND
In Tajikistan, the data collection and analysis is done by different institutions which focus on different fields of information, have different responsibilities, data garnering and processing methods and follow different reporting lines. This lack of comprehensive Health Information System (HIS) has determined the Ministry of Health to put the development of a Health Management Information System (HMIS) on the reform agenda and to adopt the HMIS Strategy for 2006-2010. Previous projects by donor organizations revealed that development of a comprehensive Health Information System for Tajikistan needs to address a number of factors, which go far beyond the mere data collection processes, such as strategic development, management, capacity building, organizational and legislative support, improvement of infrastructure, institutionalization, and integration of Health Information System into the policy and development framework in line with the National Health Strategy 2010-2020 adopted by the President of Tajikistan in August 2010, and with broader health Sector Wide Approach (SWAp), which has steadily started to develop.
In April 2010, the second phase of support to the HIS modernization (HIS II) funded by the EU started, building on the results achieved under HMIS Phase I (November 2008 - October 2009). The project's counterpart in the Ministry of Health (MoH) is the Republican Centre for Statistics and Medical Information (RCSMI). The project uses Health Metrics Network (HMN) guidelines in the Health Information System strategic planning process, creating a consensus among MoH and its partners over a selected list of HIS strengthening priorities and interventions over the coming years.
The overall objective of the HIS II project is to contribute to a more effective and modern health care system in Tajikistan.
The specific objective is a strengthened Health Information System producing relevant data and quality information through support provided to key institutions namely the State Committee for Statistics, the Republican Centre for Statistics and Medical Information, the Sanitary and Epidemiology Services and the Civil Registration Office.
Project results include: (i) HIS Strategy developed following WHO Health Metrics Framework and standards; (ii) HIS leadership and coordination mechanism strengthened; (iii) a modernized HMIS system that produces relevant data and quality information to support health interventions; (iii) a modernized Civil Registration system that produces relevant data and quality information to support health interventions.
More specifically, the HIS II project supports the existing list of national health indicators and aims at their consolidation/rationalization based on the National Health Strategy 2010-2020 (NHS 2010 -2020). Another stream of work is updating the HMIS data collection forms and enhancing the data flow and data quality through working with RCMSI and statistical centers in the Oblasts and rayons, The project also works with the Ministry of Justice and RCMSI to help improve the registration of vital events through the Civil Registration (CR) system to ensure availability of vital statistics with
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acceptable quality for monitoring the progress of National Health Strategy and the Millennium Development Goals (MDGs).
In July 2011, the MOH has adopted the Health Information System Strategic Plan for 2011-2015 - a result of a consolidated effort of many national stakeholders and Development Partners in finding broad consensus over key priorities of development of the HIS in the country,
The HIS Strategic Plan specifics the following objectives: to improve national HIS policies, regulations, procedures and coordination mechanisms; to ensure that there is adequate capacity and resources in key institutions to manage the developing national HIS; to build the infrastructure required to both computerize the primary and secondary forms and to roll out the adapted DHJS2 system, including purchasing and installation of necessary equipment in a number of rayons/oblasts; to improve Health Indicators; to improve work on collection of data complying with standards; to achieve complete coverage and improve accuracy and reliability of Registration of Births and deaths; to better integrate population-based surveys and make better use of the data produced; to improve the contents, integration and use of health and disease records ; to improve the management and quality of health service records; capacity building (data collection & analysis at republican, oblast, rayon & facility level & HIS software applications); to improve mortality data quality; to improve data quality morbidity; to improve risk factor data and information capture through periodic surveys and database development; to improve capacity for exchange, management, analysis, dissemination and use of data; to improve ICT infrastructure for better data exchange; to improve the use of informational technologies for the development and support of the market of medical services; use of HIS data on district and sub-national management for resource allocation in annual budget; to strengthen information-based decision-making mechanism.
The EU will continue to strengthen capacities of key national and sub-national institutions involved in the implementation of the recently adopted HIS Strategic Plan of Health Information System Development in Republic of Tajikistan, in the frame of HIS III project, planned to start early 2012 (Technical assistance component) and end of 2012 (supply of IT and network component).
2. DESCRIPTION OF THE ASSIGNMENT
2.1	Global objective
The global objective of the assignment is to contribute to effective and efficient implementation of the National Development Strategy (long term development strategy) and subsequent Poverty Reduction Strategy Papers (medium term development strategy), particularly in the area of Health Information Systems.
2.2	Specific objective
The specific objective of the assignment has two components:
2.2.1 Component 1 - An end of project evaluation of the "Development of an HMIS in Tajikistan" Project CHIS ID
The purpose of the evaluation is to draw out lessons from the experience of project implementation that will feed into Component 2 (see below). Stakeholders in the Government of Tajikistan and the European Commission, as well as project management, are expected to take an interest in the report.
The main objectives of the evaluation are therefore to determine:
(i)     The success of the project in producing the planned results and achieving its purpose;
(ii)    The lessons learned from experience to date that may be used to plan future activities.
2.2.2. Component 2 - to develop Terms of Reference for the "Technical Assistance to support the Strengthening of the Health Information System in Tajikistan" project (HIS III)
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It is expected that the project will enable the Tajik authorities to follow up more effectively the objectives, outputs and outcomes as defined in the National Health Strategy for 2010-2020, adopted through the Decree No 368 of the government on 2 August 2010. The project foresees to provide support to capacity development of the national stakeholders in order to effectively implement the Strategic Plan of Health Information System 2011-2015 in Tajikistan, approved through MoH Order no 579 on 5 July 2011. Preliminary findings regarding expected project results foresee increased national and sub-national capacities for (i) gradually achieving complete coverage and improve accuracy and reliability of registration of births and deaths; (ii) improvement of the contents, integration and use of health and disease records; (iii) improvement of the management and quality of health service records; (iv) effective management, analysis, dissemination and use of health data and information serving enhanced government policy development.
The main objectives of the study are therefore to determine:
(i) All necessary components, inputs and activities for the envisaged new project, and proposed options for its institutional set-up, focusing attention to existing and forecasted projects, needs and development opportunities, the present context and the capacities of the public administration system.
(ii) A detailed Stakeholders' analysis, implementation arrangements as well as technical and institutional needs. This will include the preparation of a SWOT analysis and the exploration of links and synergies with other projects and local counterparts active in similar areas.
(iii) The potential impact of the proposed action as well as its sustainability identifying obstacles and risks to die achievement of the desired impact taking account of cross-cutting issues (environment, human resources development, regional cooperation, poverty alleviation and gender) and financial and economic considerations. Possible measures ensuring sustainability are identified and described. This refers in particular to the recurrent cost implications for the government.
The scope of the action has to be carefully determined in view of existing constraints (e.g. budget, technical and institutional obstacles). The quality of the TOR will be essential in getting other stakeholders and the Tajik government on board.
2.3        Requested services
The following methods will be undertaken to complete the assignment. See section 4 for a proposed work schedule.
2.3.1 Component 1 - An end of project evaluation of the "Development of an HMIS in Tajikistan" project fHIS II)
(i)    Review of Relevant Documentation
Relevant documentation will be provided to the consultant team such that they have sufficient knowledge of the programme in advance of starting work in the field. The documentation will include (but not limited to):
Financing Agreement (FA)
Support to HIS II Inception and six-monthly Progress Reports
Result Oriented Monitoring sheet
Various Programme Technical and Monitoring Reports (HIS TA Team)
(ii)  Evaluation Criteria
The usual evaluation criteria - relevance, efficiency, effectiveness, impact and sustainability - will apply. Given the timing of the evaluation in project life span, emphasis for this evaluation should be
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placed on effectiveness, impact and sustainability. The project components should be assessed individually and collectively.
An important reason for this evaluation is to learn lessons that may be of use during the drafting of the TOR under component 2.
There are a number of projects and programmes active in the same field in MOH and unified approaches are essential for success. The end of project evaluation should provide an insight in consistencies and inconsistencies of various approaches and how better synergies could be achieved,
(iii) Study Techniques and Research Methods
The consultant will be expected to review project documentation, interview project management and field staff, co-operating government national and provincial officers, other donors with existing or planned similar programmes. Field visits will be undertaken to meet staff, officials and beneficiaries. Care should be taken to obtain the views of project beneficiaries in a participative manner. The project logical framework should provide the basis of analysis.
2.3.2.	Component 2 - to develop Terms of Reference for the "Technical Assistance to support the
Strengthening of the Health Information System in Tajikistan" project CHIS III)
(i)   Review of Relevant Templates
Reference to the template for the TOR document is included in the current Terms of Reference and therefore known by the Consultant team prior to mobilization so that the team is aware of the final outputs that need to be aimed for. Knowledge of this template will help the team structure its activities.
2.4        Required outputs and reporting
2.4.1. An Inception Report in English, of not more than 5 pages, will be submitted to the EC Delegation for approval 5 days after the arrival of the Consultant team in Dushanbe. The inception report should present the proposed mission revised time-schedule (including a tentative schedule for the field visits) and details of the activities foreseen by the mission under both components.
Component 1 - An end of project evaluation of the "Development of an HMIS in Tajikistan" project fHIS ID
The consultant will produce:
2.4.2 A stakeholder's workshop (or possibly just the steering committee), at which the evaluation findings will be presented, together with a set of PowerPoint slides in Dushanbe.
2.4.3.	A Draft Evaluation Report in English and Russian to be completed no later than Day 10 of the total experts' assignment and submitted to the EC Delegation in Dushanbe (see template in Annex 2)-
2.4.4.	Within one week of receipt of the draft report the EC and the MOH will forward their detailed comments to the Consultants. A Final Evaluation Report in English and Russian will then be completed within three working days and transmitted by the Consultants to the Delegation in Dushanbe.
2.4.5.	Once finalized, 7 hard copies in English and Russian should be provided to the Programme Manager of the EC Delegation in Dushanbe. Furthermore, an electronic copy of all files is to be transmitted by e-mail, simultaneously with the submission of die draft and final documents, to the EC Delegation in Dushanbe.
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The main text of die evaluation report (excluding Executive summary and annexes) should not exceed 40 pages. The Executive summary should not exceed five pages.
Component 2 - to develop Terms of Reference for the "Technical Assistance to support the Strengthening of the Health Information System in Tajikistan" project (HMIS III)
The consultant will produce:
2.4.6.	A written Aide Memoir (maximum 8 pages) to be presented in English as a basis for discussion at wrap-up meetings with Government, EC Delegation and other interested parties (such as the steering committee and ministerial working group) in Dushanbe. To this aide memoir, preliminary draft documents (draft Logical Framework Matrix and budget -shall already be annexed for the EC Delegation perusal and comments. This proposal should be sufficiently clear, follow an appropriate logic, take into account lessons learnt under HIS II and introduce sound justification for the options chosen;
2.4.7.	A stakeholder's workshop (such as the steering committee) at which draft proposal for a follow-up phase will be presented, together with a set of PowerPoint slides in Dushanbe. The workshop will be followed by discussions between the Consultant Team, the EC Delegation, MOH representatives and other Stakeholders.
2.4.8.	At the latest on Day 22 since mission start, a 1^st Draft TOR (and its attached Logical framework Matrix and budget) in English and Russian will be submitted to the EC Delegation in electronic format (see annex 3 for template) and at latest on Day 32 since start of assignment a final TOR and its attached LFA matrix and the budget.
2.4.9.	Pre-assessment of IT needs and network equipment to complement the Technical Assistance component described in the TOR to be submitted to the EU Delegation three days before the end of site work in Tajikistan.
2.4.10.	Draft Final Report in English and Russian will be submitted to the EC Delegation. Within one week of receipt of the draft report the EC and Government of Tajikistan will forward their detailed comments to the Consultants. A Final Report in English and Russian will then be completed within three working days and transmitted by the Consultants to the Delegation in Dushanbe. The Final Report will contain the TOR, the Pre-assessment of IT needs and network equipment and logical framework matrix as annexes.
Once finalized, 7 hard copies should be provided via express courier service to the Task Manager in Dushanbe. An electronic copy of all files is to be transmitted by e-mail, simultaneously with the submission of the above reports, to the EC Delegation in Dushanbe.
3. EXPERTS PROFILE
The team will consist of two Senior Experts (out of which one will be the team Leader), having considerable experience in evaluating and designing programmes in the areas of HIS/HMIS.
The total number of man-days for the team, including travel, will not exceed 95 working days (see planning in section 4).
All experts will be broadly familiar with project approaches, project cycle management and the logical framework approach. Experience in the development sector in Tajikistan is desirable, but much greater emphasis will be placed on technical expertise in assessing and formulating large HIS/HMIS projects.
The Mission Leader will be responsible for quality and consistency of the reports. Each expert must be fluent in English. A working knowledge of Russian/Tajik would be an advantage.
Number of requested experts per category and number of man-days per expert or per category
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For the implementation of this project, one Team Leader/Senior Expert for a period of maximum 49 working days and one Senior Expert for a period of maximum 46 working days are sought.
> Profile per expert
3.1	Expert 1 -	Team leader / Health Information Systems ( HIS) Expert
Estimated input: 49 man-days.
Qualification and skills:
University degree in Public Health or equivalent
Fluent in written and spoken English, knowledge of Russian or Tajik would be an asset
General Professional Experience:
At least 10 years experience in design and implementation of projects reforming the health sector out of which at least five years of professional experience in developing countries preferably including countries of the Commonwealth of Independent States
Specific Professional Experience:
Proven experience through at least one project entailing at least two of the following fields: (i) vital statistics (improvement of registration of births and deaths); (if) management and quality of health service records; (iii) analysis, dissemination and use of health data and information serving enhanced government policy development; (iv) health indicators for evidence-based management
At least four years of successful experience in implementing projects in the area of HMIS Prior experience in project evaluations and project preparation, design and planning Experience of leading a team of experts -    Proven experience in working with governmental institutions
3.2	Expert 2 -	Health Information Systems (HIS) Expert
Estimated input: 46 man-days.
Qualification and skills
Academic level in a subject related to HMIS
General professional experience:
At least 10 years experience in design and implementation of projects reforming the health sector out of which at least five years of professional experience in developing countries preferably including countries of the Commonwealth of Independent States
Specific professional experience
Knowledge or hands-on experience with design and implementation of HIS infrastructure
plans. Familiarity with open source DHIS 2 application is an asset
At least four years of successful experience in design and or implementation of projects in the
area of HMIS
Prior experience in project evaluations and project preparation, design and planning
4. LOCATION AND DURATION
>	Starting period: The project is expected to start on 05 September 2011.
>	Foreseen finishing period or duration: The project is expected to end not later than within 120
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calendar days following the start of the assignment (including the submission of and agreement upon the final TOR and reports).
> Planning including the period for notification for placement of the staff as per art 16.4 a)
The assignment will be organized over a total of 95 working days tentatively distributed as follows:

| Senior Expert 1/ Team Leader | Senior Expert 2
Background reading — home based | 2 | 2
Travel | 1 | 1
Site work in Tajikistan on End of project Evaluation HIS II | 10 | 10
Reporting | 3 | 3

Site work in Tajikistan on drafting TOR for
HMism

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16

Site work on a preliminary draft of needed IT and network equipment that will complement the Technical Assistance component under HIS III | 10 | 10
Reporting | 3 | 3
Travel | 1 | 1
Work at home on final report | 3 | -
Total working days | 49 | 46
> Location of assignment
The project activities will take place in Dushanbe, Tajikistan, with possible visits in the field.
5.	REPORTING
Cf. paragraphs 2.4 above.
6.	ADMINISTRATIVE INFORMATION
6.1.	Interviews
No interview required.
6.2.	Sub-contracting
No sub-contracting is allowed under this assignment.
6.3.	Language
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Language of the contract will be English.
6.4.	Request for a succinct methodology N/A.
6.5. Other remarks
During contacts with the Tajikistan authorities or any other organisation, the consultants will clearly identify themselves as independent consultant and not as an official representative of the European Union Delegation.
These terms of reference may be elaborated further by the EU Delegation during briefings in Dushanbe. Attention is drawn to the fact that the European Commission reserves the right to have the reports redrafted by the consultant as many times as necessary to achieve an acceptable quality of Final Report.
Financial penalties will be applied if schedules indicated for the submission of reports (draft and final) are not strictly adhered to (article 19 of General Conditions).
Eventually, it is reminded that the use of "lump sum" as a unit in the submitted budget is not allowed.
List of Annexes:
-	Annex I: Logical Framework HMIS II
-	Annex II: Evaluation report format
-	Annex III: TOR template
S

ANNEX I - LOGICAL FRAMEWORK HMIS II

To contribute to a more effective and modern health care system in the Republic of Tajikistan

Improved availability of strategic health
information for the MoH and its partners to
respond to public health problems	

National Health Statistics, Unified Health Information System, Policy Papers

MoH and other key partners are motivated to collaborate and reach consensus

PURPOSE; r,5V$l&^J^'

f |r $M*-^X*

A strengthened Health Information System producing relevant data and quality information through support provided to key institutions (SSA, RCMSI, SES, and CRO)

0 I Enhanced outline of the Health
Statistical Yearbook
0.2 Concept and methodology for
sustainable quality improvement of data and
information are developed and ready for
application
0.3 The DHIS2 (software) implementation
plan is drafted, verified/tested and approved
by RCSMI	

Outline for an improved Health Statistical Yearbook
Concept paper (roadmap and guidelines)
Implementation plan

Commitment and political will for change by all HIS key stakeholders
Cooperation of RCSMI
Cooperation of counter partners

RESULTS-

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Component 1: HIS

Result 1-1: HIS strategy' developed following WHO Health Metrics Framework and standards
Result 1-2: HIS leadership and coordination mechanism strengthened

1.1. Final HIS Strategic Plan
1.2.a. HIS Strategic Plan is developed by the designated group comprising of MoH, SSA, CRO and others, and approved by the order of the MoH.
1.2 b Active involvement of international agencies to support development and implementation of the HIS Strategic Plan

Final Strategic Plan endorsed by PSC & MoH
Order of the MoH on the establishment of HIS Strategic Plan working group (December, 2010)
Minutes of meetings for HIS Strategic Plan development and of Project Steering Committee Meeting
Order of the MoH on

Cross-sectoral consensus on the new HIS approach
Cross-sectoral consensus on the new HIS approach

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^B^^^^^^^^^^^^^^^H | | | ^^^^^^^^o^^^^^^^m
| | approving the HIS Strategic Plan |
Component 2 | | |

Result 2: A modernized HMIS system that produces relevant data and quality information to support health interventions

2.1.	Metadata dictionary of core indicator
set published
2.2.	Instruction manual on revised recording
forms (primary forms) published
2.3 Recording and Reporting forms review and revision completed

Core Indicator Set, Metadata Dictionary Updated instruction manual Revised forms

Cooperation of counter partners and readiness to revise indicators and forms

Component 3 | | |

Result 3: A modernized Civil Registration system that produces relevant data and quality information to support health interventions

3.1.	Detailed CR implementation plan
incorporated in the HIS strategic plan
3.2.	Report with technical specs and costing
for computerisation of the Civil Registration
System

HIS strategic planning Reports on revised fonns, and recommendations for computerization

Ministry of Justice is committed to work with MoH
and is open to its recommendations for CR
enhancement
Enough financial and human resources to set up and
maintain required infrastructure (software and
hardware)

ANNEX 2 - FINAL EVALUATION REPORT FORMAT
I	- Executive Summary: Should be no more than five pages. It should focus mainly on the key purpose or issues of the evaluation, outline the main analytical points, and clearly indicate the main conclusions, lessons learned and specific recommendations. Cross-references should be made to the corresponding page or paragraph numbers in the main text that follows.
II	- Main Text: Should start with an introduction describing, first, the project evaluated and, second, the evaluation objectives. The core of the report should follow the five evaluation criteria - relevance, efficiency, effectiveness, impact and sustainability - describing the facts and interpreting or analysing them in accordance with the key questions pertinent to each of the criteria.
III	- Conclusions and Recommendations: These should be the subject of a separate final chapter.
Wherever possible, for each key conclusion there should be a coresponding recommendation. The
key points of the conclusions will vary in nature but will often cover aspects of the key evaluation
criteria, that is:
i.	Relevance - whether the design of the project was originally, and still is, sound as regards
targeting the real needs and problems of the right beneficiaries; quality of the log frame,
clarity of objectives, purpose and results; appropriate specification of indicators.
iL	Efficiency - quality of project management; whether the same result could have been
achieved at lower costs; or whether there might have been different, more appropriate ways of achieving the same results; quality of monitoring and MIS. Hi,        Effectiveness - whether the planned benefits were in fact received,  whether the beneficiaries' behavioural patterns changed, whether neglect of cross-cutting issues is affecting the achievement of the project purpose; have there been any unplanned results. iv.        Impact - the wider outcomes for a larger group of persons or for society as a whole; the
successes and failures in achieving the overall objectives, and the main reasons why;
v.	Sustainability — whedier the flow of benefits to the beneficiaries, and to society generally,
is likely to continue or not, and why; assessment of levels of ownership of activities and assets, institutional capacity, adequacy of budgets/finances, technical and socio-cultural factors in maintaining streams of benefits. The ultimate value of the review depends on the quality and credibility of the recommendations for future interventions offered. Recommendations should therefore be as realistic, operational and pragmatic as possible; that is, they should take careful account of the circumstances currently prevailing in the context of the project, and of the resources available to implement them.
IV	- Annexes: the report should include the following annexes:
1.	Terms of Reference of the review
2.	Names of the evaluators (summary CVs should be attached) and company
3.	Methodology applied for the study (phases, methods of data collection, etc.)
4.	Logical Framework matrices (original and improved/updated)
5.	Map of project area, if relevant
6.	List of persons/organisations consulted
7.	Literature and documentation consulted
8.	Other technical annexes (e.g. statistical analyses)
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