- BACKGROUND
- The GOJ has received two loans from the Inter-American Development Bank (IDB) to support the HSSP. In addition, the GOJ has also been provided with an investment grant from the European Union (EU) to support the implementation of the Programme. The objective of the HSSP is to improve the health of Jamaica’s population by enhancing comprehensive policies for the prevention of non-communicable diseases (NCD) risk factors and for the implementation of a chronic care model (CCM) with improved access to strengthened and integrated primary and hospital services networks that provide more efficient and higher-quality care.
- The HSSP, is a hybrid Programme with a policy-based operation; a Programmatic policy-based loan series (PBP); and an investment loan. The PBP seeks to consolidate regulatory measures to address the preventable causes of NCDs and to reorient health systems to address prevention and control of NCDs through a people-centred, primary-health CCM. The investment loan will fund the improvement of physical infrastructure and medical equipment of Jamaica’s health sector. Additionally, the investment component, in turn, will finance activities to consolidate integrated health networks and improve the management, quality and efficiency of health services. While the PBP will benefit the Jamaican population at large, the investment loan will have approximately 800,000 direct beneficiaries who reside in the catchment areas of the health services networks that will receive investments.
- The MOHW redefined the scope of HSSP, requiring additional financial resources and an extension to the execution period. The initial Spanish Town Hospital (STH) plans within HSSP needed to be revised to meet the hospital services demands of the St. Catherine Parish population. Because of this, the MOHW decided to scale up the STH project, expanding its size and including new specialized medical and surgical services.
- The gaps in ambulatory health services supply-demand, and the conditions of the health centres (HCs) prompted planning to build four new HC, expand four, rehabilitate two, and procure medical equipment for all ten (10) HC. There is also the need to enhance the HCs to include new services such as maternity and dental care and expand laboratories and pharmacies.
- Considering the situation described earlier, on July 29, 2022, the GOJ expressed its commitment to proceed with reformulating the loan) into two phases. Phase 1 is to focus on the rehabilitation, construction, and procurement of medical equipment for STH (Component 1 of the loan). While Component 2 of the loan, will comprise the implementation of the digital health platform in thirteen (13) facilities, introducing the CCM, and conducting the Jamaica Lifestyle Survey. As for the European Union (EU-CIF IGR) Climate Investment Fund Investment Grant (GRT/ER‑17830‑JA), the Phase 1 will involve the building of one (1) new HC and expanding two (2) HC, instead of the ten (10) HC originally planned.
- The reformulation of HSSP will include supplementary financing provided by the GOJ to increase both the capacity of STH and three (3) HC in its area of coverage. The civil works in STH and the three (3) health centres have been significantly rescoped to strengthen: a) the supply capacity of the primary care services in the HC; b) the medical specialties; and c) the surgical capacity of STH. The rescoping of these facilities seek to satisfy existing unmet health services demand and consequently increase access to and improved quality of health care to the population of the Parish of St. Catherine. The total estimated cost for Phase 1 is US$100.6 million, which is to be co-financed by GOJ, IDB and EU‑CIF.
- LOAN DESCRIPTION
- The general objective is to improve the health of Jamaica’s population by strengthening comprehensive policies for preventing non-communicable diseases risk factors and improving access to an upgraded and integrated primary and secondary health network in prioritized areas. The specific development objectives continue as originally stated: (i) to provide more efficient and higher quality of care for patients with chronic non‑communicable diseases; (ii) to improve access to an upgraded and integrated primary and secondary health network in prioritized areas with an emphasis on chronic disease management; and (iii) to strengthen comprehensive policies to prevent non‑communicable disease risk factors.
- Component 1. Organization and consolidation of integrated health services networks. This component will finance two subcomponents. Subcomponent 1.1 will fund the completion of design and costing for thirteen (13) facilities (three hospitals and ten clinics), upgrade and expansion of STH (1.10 and 1.25), purchase of medical and imaging equipment, construction supervision services, sewage works for all thirteen (13) facilities and implementation of a corrective and preventive maintenance Programme. The designs for the thirteen (13) facilities will incorporate measures for universal accessibility, resiliency, energy efficiency and the sewage studies. Subcomponent 1.2 will finance the construction of Old Harbour HC, expansion of St Jago Park HC, and Greater Portmore HC, and the procurement of medical and dental equipment for these tree HC as well as an additional two Health Clinics.
- Component 2. Improvement of management, quality, and efficiency of health services. This component will fund: (i) Subcomponent 2.1: (a) The CCM implementation in participating health services networks and preparatory work for change management, continuous quality improvement and social marketing for behavior change strategies and improve health services in thirteen (13) health facilities for patients with NCDs, including persons living with disabilities, and (b) implementation of the Fourth Jamaica Health and Lifestyle Survey; and (ii) Subcomponent 2.2: the digitalization of health care services that comprise: (a) the creation of a strong foundation for a digital health ecosystem, (b) the implementation of a sustainable Electronic Health Record platform, and (c) the implementation of telehealth, telemedicine, and tele mentoring services. It also involves implementing the communication and visibility plan including mHealth rollout and publicizing the EU-CIF contribution supporting HSSP.
- LOAN DESCRIPTION
The general objective is to improve the health of Jamaica’s population by strengthening comprehensive policies for preventing non-communicable diseases risk factors and improving access to an upgraded and integrated primary and secondary health network in prioritized areas. The specific development objectives continue as originally stated: (i) to provide more efficient and higher quality of care for patients with chronic non‑communicable diseases; (ii) to improve access to an upgraded and integrated primary and secondary health network in prioritized areas with an emphasis on chronic disease management; and (iii) to strengthen comprehensive policies to prevent non‑communicable disease risk factors.
- Component 1. Organization and consolidation of integrated health services networks. This component will finance two subcomponents. Subcomponent 1.1 will fund the completion of design and costing for thirteen (13) facilities (three hospitals and ten clinics), upgrade and expansion of STH (1.10 and 1.25), purchase of medical and imaging equipment, construction supervision services, sewage works for all thirteen (13) facilities and implementation of a corrective and preventive maintenance Programme. The designs for the thirteen (13) facilities will incorporate measures for universal accessibility, resiliency, energy efficiency and the sewage studies. Subcomponent 1.2 will finance the construction of Old Harbour HC, expansion of St Jago Park HC, and Greater Portmore HC, and the procurement of medical and dental equipment for these three HC as well as an additional two Health Clinics.
- Component 2. Improvement of management, quality, and efficiency of health services.
This component will fund: (i) Subcomponent 2.1: (a) The CCM implementation in participating health services networks and preparatory work for change management, continuous quality improvement and social marketing for behavior change strategies and improve health services in thirteen (13) health facilities for patients with NCDs, including persons living with disabilities, and (b) implementation of the Fourth Jamaica Health and Lifestyle Survey; and (ii) Subcomponent 2.2: the digitalization of health care services that comprise: (a) the creation of a strong foundation for a digital health ecosystem, (b) the implementation of a sustainable Electronic Health Record platform, and (c) the implementation of telehealth, telemedicine, and tele mentoring services. It also involves implementing the communication and visibility plan including mHealth rollout and publicizing the EU-CIF contribution supporting HSSP.
- COMPONENT 1 OBJECTIVES
In keeping with Component 1 “Organization and consolidation of integrated health services networks’’, the Programme aims to improve health services delivery in three (3) hospitals and ten (10) health centres namely:
Hospitals:
1) Spanish Town Hospital
2) St. Ann’s Bay Regional Hospital
3) May Pen Hospital
Health Centres:
4) St Jago Park Health Centre
5) Old Harbour Health Centre
6) Greater Portmore Health Centre
7) St Ann’s Bay Health Centre
8) Ocho Rios Health Centre
9) Brown’s Town Health Centre
10) May Pen West Health Centre
11) May Pen East Health Centre
12) Mocho Health Centre
13) Chapelton Community Hospital
- OBJECTIVES OF THE CONSULTANCY
The Clerk of Works will assist the Project Engineer in overseeing on site the execution phase of the project described in section 5 of these Terms of Reference (TOR). This role entails verifying and informing the Site Engineer about the works execution in terms of timely duration, high-quality completion, compliance with design specifications, schedules, budgets, the relevant Environmental, Social, Health and Safety (ESHS) standards and the Works Contractors Code of Conduct requirements specified in the Works Contracts. The Consultant will play a crucial role in ensuring the quality, compliance, and adherence to specifications during construction projects. This position also involves coordinating with the Project Executing Unit and Contractors in maintaining detailed records of project progress. The Clerk of Works Consultant will be responsible for providing services at any of the listed locations below:
- St Jago Park Health Centre (Expansion and Renovation)
- Old Harbour Health Centre (New Construction)
- Greater Portmore Health Centre (New Construction)
- Old Harbour Waste Water Treatment Plant (New Construction)
- Description of the Works to be Supervised
The Works are:
Lot 1 Old Harbour Health Centre
The project site is located in the town centre in proximity to the Old Harbour Market. The available area for the project site is estimated to approx. 9,680 sq. m. The land will be surrounded by a perimeter wall and fencing. A basketball playground is located in the eastern part of the site, but its current setting blocks the development of the land and the future driveway that will lead to the proposed parking lot. However, as the local community frequently uses it, it will be relocated to the southern part of the plot. The main vehicle and pedestrian access is defined from the north, from East Street. A check point that is going to be controlled by a security guard is planned to serve the plot entrance.
The proposed building will be situated in the western part of the plot, perpendicular to the East Street and parallel to the internal street, which serves the area. The proposed new one-story building is approx. 1,995 sq. m with a nearly rectangular shape footprint. Close to the building, on the south side and with direct connection to the main plot access, a parking lot for 40 vehicles will be included. Three parking spaces are designated for disabled people. An ambulance parking lot is provided on the north side of the building near the main vehicle and pedestrian access, close to the security post. An allocated area for landscaping and recreation is situated to the south to ensure that the outdoor spaces are pleasant areas for staff and patients. The basketball playground is part of this recreational area. The recreational area could be fenced and separated from the health centre property and thus it could also be used as a new community outdoor space.
An area for positioning additional facility infrastructure will be provided. The facilities are grouped and located to the north, between the existent building and the north façade of the new health center. Their location has been chosen as close as possible to the main plot entrance in order to provide convenient access and to facilitate building management and support. They will include:
- HVAC system
- Facility Generator
- Facility Medical Waste Storage – Medical (infectious waste) and Solid Waste storage (general waste)
- Facility Water Storage
Facility Alternative Energy connections will be included for future acquisition e.g. a photovoltaic system, mounted on the roof.
Lot 2 Greater Portmore Health Centre
The project site is allocated on the south of the existing facility. The available area for the project site is estimated at approx. 4,500 sq. m. that includes part of the existing site and the adjacent site to the south-west. The land will be surrounded by a perimeter wall and fencing. Currently, the main access to the plot is from the west, from SW 1st Ave. A private road, which already exists and connects with SW 1st Ave, serves the hospital plot and the new extension. The building is oriented towards the north-west. The space is sufficient; however, it is situated on an existing field that is used by the local community as a football playground. The field will be relocated.
The proposed new one-story building is approx. 1,260 sq. m with a U-shaped footprint. It is situated on the southern part of the plot. A parking lot for 30 vehicles is to be included and positioned in close proximity to the building. Three spaces are designated for disabled people. An allocated area for landscaping and recreation is situated to the north to ensure that the outdoor spaces become pleasant areas for patients.
An area for positioning additional infrastructure will be implemented. It will include:
- Facility Generator & Alternative Energy
- Facility External (Sewer disposal system)
Lot 3 St. Jago Park Health Centre
St. Jago Park Health Centre is located in close proximity to the St. Catherine Health Department and neighboring Spanish Town hospital.
The proposed new development includes reconfiguration of the existing facilities equal to approx. 1,137 sq. m and a new one story building approx. 694 sq. m with a rectangular footprint. The new building is to be situated in the central part of the plot, on the site of an existing parking lot with direct connections to the existing buildings of the health facility and to the existing conference room building. A new parking lot for 36 vehicles will be situated in the southern part of the plot. Due to the adjacent river and the possible risk of flooding, a higher floor lever for the new extension is designed. The possible height difference between the levels of the new and the existing building will be addressed with an access ramp.
The land will be surrounded by a perimeter wall and fencing. Currently, the main access to the plot, where there is a single existing security checkpoint, is from the north-west, from Burke Rd. One more access point will be included that will directly connect the St. Jago Park health centre with the Spanish Town Hospital.
An area for positioning additional infrastructure will be implemented. The facilities are grouped close to the north façade, behind the existing conference room building. They will include:
- Facility Generator;
- Facility Water Storage.
Facility Alternative Energy connections will be included for future acquisition e.g. a photovoltaic system, mounted on the roof.
- ORGANIZATION OF ST. CATHERINE HEALTH FACILITIES SUPERVISION
The Component 1 Organization and relationships are shown in Figure below
- SCOPE OF WORK (SOW)
The Clerk of Work’s scope of work to include:
- Quality Control and Improvement
- Compliance Monitoring
- Documentation and Record Keeping
- Communication and Coordination
- Technical Support
- Budget & Schedule Monitoring
- Project Support
- KEY TASK AND RESPONSIBILITIES
The Consultant will:
Quality Control and Improvement
- For each phase of the works, i.e., mobilization, construction and defects notification and post-construction, maintains an effective and sufficient quality assurance procedure and monitor execution of the works and execute quality control measures (regular inspections, tests, etc.) to ensure that construction work meets quality standards, specifications, and regulatory requirements.
Compliance Monitoring
- Monitor construction activities to ensure compliance with building codes, safety regulations, and contractual agreements. Including check building regulations, health and safety, and legal and ecological (NEPA/WRA) requirements are met.
- Through on-site inspection, determine if any materials or plant are, or are likely to be, defective or otherwise not in accordance with the Works Contract
- Report to the Project Engineer on compliance by the Contractor with respect to sub-contracting, as specified in the Works Contract.
Documentation and Record Keeping
- Maintenance of site diaries
- Monitoring and expediting weekly reports or incidental reports for accuracy.
- Maintain accurate and detailed records of construction progress, inspections, and any deviations from plans or specifications. This includes referring to plans and taking photographs of work, along with measurements and samples Identifying defects and suggesting ways to correct them.
- Witness and document testing of systems and components.
- Prepare digital and physical archive for hand over to PEU.
Communication and Coordination
- Communicate effectively with all stakeholders regarding construction progress, issues, and resolutions during each phase of the works.
- Report on site activities and inspections to ensure work proceeds according to schedule.
Technical Support
- Assist in resolving technical issues, conflicts, and challenges that may arise during construction and the defects liability period
- Work closely with architects and engineers to ensure design intent is realized.
Budget, Financial Management and Schedule Monitoring
- Monitoring delivery and use of construction materials on and off site, site personnel present, etc.
- Track construction progress and milestones to ensure project timelines are met.
- Assist Project Engineer with reviewing and verifying the Contractor’s progress for payment certification.
- Review the Contractor´s monthly report of the estimated value of the work executed regarding:
- the quantities of works actually executed by the Works Contractor,
- compliance with the technical and quality specifications of the materials and construction processes, and
- The physical-financial progress of the Works.
Project Support
- Participation in project meetings, site meetings and technical meetings as required by Project Lead
- Collaborate with MOHW internal and external stakeholders
- Document and journal all construction activities with photos and videos
- Prepare monthly reports for submission to the Project Lead with detailed documentation of implementation successes, challenges or issues including any breaches incurred by the Works Contractor, as stipulated in the Works Contract.
- Assist consultants as needed or directed by Project Lead
- Perform other duties as determined by the Project Lead
- Submit other ad hoc reports as determined by the Project Lead
- SUPERVISION & REPORTING
The Clerk of Works will be supervised by the Project Lead and indirectly by the Project Manager, Infrastructure and Investments of the HSSP ; and will frequently liaise with all relevant members of staff of the Project Executing Unit (PEU) and the MOHW including the Permanent Secretary, Administration, Procurement, Financial and Technical Officers.
The Clerk of Works will:
- Maintain daily log of activities and resources (equipment, personnel, etc.), daily weather conditions in the site diary
- Prepare detailed monthly reports for submission on construction activities
- Prepare meeting notes as required
- Document all construction activities with photos and videos, with detailed documentation of problems or issues
- IMPLEMENTATION ARRANGEMENT
- The Consultancy Services will be implemented for a period of twelve (12) months for the duration of the construction phase, Defects Liability Period (DLP) and the installation of medical equipment and furniture.
- The contract amount will be distributed in monthly payments during the period of active construction that will be dependent on satisfactory implementation of activities and delivery of required products, as agreed between the MOHW, PEU and the Consultant
- Coordination meetings will be conducted between the MOHW, PEU and the Consultant for the duration of the project, as needed.
- The Project Manager or any of their representatives will provide the Consultant with the necessary documents/support to enable the performance of the activities.
- Ministry of Health and Wellness through the PEU will be the executing agency and main recipient for the Consultancy Services with the Programme.
- COST OF CONSULTANCY SERVICES
- The contract for this consultancy is deliverables-based contract, inclusive of tax and other incidental expenses and printing of reports/deliverables
- The cost shall cover the following:
- Remuneration/professional fees;
- Incidental expenses – which would include out-of-pocket expenses (e.g., supplies and materials, transportation/fuel, communication and coordination meetings)
- DELIVERABLES
Billing for remuneration/professional fees shall be in accordance with the following delivery schedule and subject to the usual Government of Jamaica accounting and auditing requirements:
| Deliverables | Delivery | |
| 1.0 | Monthly Report | Monthly – No later than 5 calendar days after the end of the reporting month to include the status of the construction, highlighting key issues on works duration, cost, quantity, and quality, risks and recommended mitigation measures; days and times worked. included with photos and videos, with detailed documentation of problems or issues. |
| 2.0 | Daily log of activities and resources (equipment, personnel, etc.), daily weather conditions in the site diary | Daily |
| 3.0 | Adhoc Reports | As required |
The deliverables shall be submitted by the Consultant in two (2) hard copies to the PEU/Ministry of Health for review. An electronic/soft copy in Microsoft Word Software or PDF shall be also submitted to PEU/Ministry of Health and Wellness.
- WORKING CONDITIONS
Below outlines the work environment, hours, travel, physical demands, safety considerations, documentations and reporting for the Clerk of Works Consultancy.
Work Environment:
- Typically works on construction sites, both indoors and outdoors.
- Exposure to various weather conditions, noise, dust, and potentially hazardous materials.
- Will require wearing personal protective equipment (PPE) such as hard hats, safety glasses, and steel-toed boots.
Working Hours:
- Generally, works full-time hours on site, which may include evenings and weekends depending on project deadlines and requirements.
- Flexible hours may be necessary to accommodate construction schedules and site activities.
Travel:
Travel to and from construction site.
Physical Demands:
- Involves walking, standing, climbing, bending, and lifting during site inspections and monitoring activities.
- Requires physical stamina and ability to navigate construction sites safely.
- REQUIRED KNOWLEDGE, SKILLS AND ABILITIES
- Understanding of civil, structural, mechanical and electrical works
- Multi-tasking, self-motivated, energetic team player
- Flexibility to adapt to changing project demands, timelines, and priorities
- Ability to work collaboratively with diverse teams and stakeholders to achieve project goals
- Excellent time management skills
- Demonstrate proficiency in reading and understanding construction plans and specifications
- ICT literate and must be familiar with Microsoft Office (Word, PowerPoint & Excel) and Autodesk AutoCAD
- Strong understanding and expression of written and verbal English
- Familiarity with measuring tools, testing equipment, and safety devices relevant to construction inspections.
- Ability to keep accurate records and prepare detailed reports
- QUALIFICATION OF CONSULTANT
- Certificate or equivalent in General Construction (Level 3), Construction Management, Building Construction or related field and Five (5) years’ experience as a Clerk of Works or similar role in construction projects
OR
- Ten (10) years’ experience as a Clerk of Works or similar role in construction projects
- Experience in new construction and renovation of healthcare related projects would be an asset.
- Experience in quality control, safety regulations, and financial management in construction projects.