1.0 Background
The adult HIV prevalence in Jamaica stands at 1.5% with an estimated 32,617 PLHIV (revised UNAIDS estimates, 2019). At the end of December 2019, almost 16% of PLHIV (5,282 persons) were unaware of their status. In 2018, 1,165 new cases were reported to the MOHW; 53% were males. Most cases (n=992, 85%) were in the 20-59 age group with males accounting for 55% of the cases in this age group. Seventy-six percent (76%) of the cases were reported in the parishes of Kingston, St. Andrew, St. Catherine, St. James, Westmoreland and Clarendon.
Jamaica continues to have both a generalized and a concentrated HIV epidemic. The HIV prevalence among men who have sex with men has remained high for nearly three decades with the most recent 2018 survey indicating 29.6% and 51% among transgender women (876 survey, 2018). The prevalence among ANC patients 0.4%, FSW is 2%, prisoners 6.9% and STI attendees 4%. Also, the 2019 Global Fund Performance Review highlights the need to strengthen the implementation of the prevention packages and testing services among key populations.
Given the evidence, there is urgent need to escalate the national response to HIV/AIDS in order to achieve local and international HIV/AIDS targets. Specifically, in light of Jamaica’s commitment to:
- The Sustainable Development Goal (SDG) which has the ambitious target to end AIDS, tuberculosis and malaria by 2030.
- The UNAIDS 95-95-95 goals to achieve epidemic control envisages that by the end of 2020, 95% of people living with HIV will know their HIV status, 95% of people who know their status will be accessing treatment and 95% of people on treatment will have suppressed viral loads.
- The 2020-2025 National Strategic Plan for Jamaica has laid out key priorities and will contribute to achieving Vision for Health 2030.
Since 1986, the National HIV/STI/TB Programme has been coordinating and leading the national response in collaboration with the Regional Health Authorities (RHAs). Funding support for the programme has included a combination of international donors such as the Global Fund, The President’s Emergency Plan For AIDS Relief (PEPFAR) and domestic resources from the Government of Jamaica. Presently the program is primarily funded by GOJ. During this pre-transitions stage the government is seeking to forge strong partnership with civil society.
Recognizing the key role of the entire society in the response, the Ministry of Health and Wellness is seeking to partner with Private Sector, NGOs and CSOs to improve delivery of HIV services to key and vulnerable populations using social contracting. This will be the mechanism for engaging entities to reach their target population in a more efficient and effective manner that contributes to the sustainability of these organizations providing HIV services and the fulfilment of the objectives outlined in the national strategic plan.
2.0 Objectives
The overall objective of this program is to control and prevent, in collaboration with the National Family Planning Board (NFPB) and National HIV/STI/TB Unit, the spread of HIV/AIDS by making prevention and testing support services more accessible to hard to reach populations such as men who have sex with men (MSM), sex workers (SW) and other high risks groups as defined by the Unit
The specific objectives:
- To increase the rate of uptake of HIV testing among the targeted population through outreach and linkage with the relevant testing services.
- To improve the psychosocial counselling support for persons living with HIV/AIDS (PLWHAs) and their families by establishing different mechanisms for support
- To improve knowledge, aptitude and practice among the key population using targeted approaches.
3.0 Scope of Work
In partnership with the HIV/STI/TB Unit of the Ministry of Health and Wellness:
- Develop HIV/STI prevention strategy to increase the reach of programmes to targeted populations. The Strategy should detail:
- The objectives of each intervention that will be undertaken by the firm
- Specific interventions that will be used to reach the population
- Types of services that will be offered to increase testing and linkage to care
- Methods that will be used to reach the populations that are defined in the national HIV prevention plan; and
- The human resources that will be required to implement the strategies as outlined
- Develop a monitoring and evaluation programme to test the efficacy of interventions and provide data that will inform the change in the programme delivery over time. The M&E Framework will define the key metrics to achieve the overall targets as set out in this TOR related to the reach and delivery of services to the key populations. The Monitoring and Evaluation programme should detail:
- The indicators of success that will be used to determine the achievements of the programme
- The means of verification that will be used to determine the assessment of each indicator
- The methodology for collecting and analyzing data related to each indicator
- The responsibilities for measurement
- Develop an implementation plan based on the strategies that have been identified. The plan will detail:
- A Gantt Chart detailing the specific activities and tasks that will be undertaken to achieve the objectives as defined in the plan
- The inputs related to each intervention and the responsibilities for each
- Activities that may be defined include:
- Providing linkage to care for all individuals testing positive.
- Activities to reduce loss to follow up (LTFU) of persons previously in public care
- The Establishment of safe and client-friendly drop-in centres that provide access to general health information and ART.
- The provisions of condoms, lubricants and other safer sex supplies to include educational materials for distribution free of charge to general public.
- Provide late night and weekend condom distribution services in select venues and locations.
- Provide access to HIV testing and counselling (HCT) services
- Monthly reports that will guide the detail the progress of activities. The consulting firm as part of the general implementation plan will be require to support the Ministry of Health in the development and implementation of new strategies to support the expansion of the reach of the programme to the key populations that have been identified.
- Maintain accurate record of clients in a manner that protects their confidentiality
4.0 Monitoring & Evaluation
The following are key indicators that will be required to reached per annum by the Firm:
| INDICATOR | Num | Den | % |
| 1. Percentage of MSM reached with HIV prevention programmes – defined package of service | 11,487 | 42,375 | 27% |
| 2. Percentage of MSM that receive an HIV test during a year and know their result | 9,190 | 42,875 | 21% |
| 3. Percentage of sex worker reached with HIV prevention programmes – defined package of service | 9,422 | 24,161 | 39% |
| 4. Percentage of sex worker that receive an HIV test during a year and know their result | 7,538 | 24,161 | 31% |
| 5. Percentage of transgender people reached with HIV prevention programmes – defined package of service | 1,423 | 3,814 | 37% |
| 6. Percentage of transgender people that receive an HIV test during a year and know their result | 1,138 | 3,814 | 30% |
5.0 Conditions of Consultancy
| SELECTION METHOD | This consultancy will be selected using a Quality and Cost Based Selection process as outlined in the Guidelines for Government Procurement Procedures; |
| PERIOD OF CONTRACT | 12 MONTHS |
| PAYMENT METHOD | Deliverable based contract |
| REPORTING ARRANGMENS | The consultant firm will report to the Executive Director of the National Family Planning Board for the implementation of activities; |
| SUPPORT | · The consultant will be required to provide all tools of trade facilitation in undertaking the assignment
· The Ministry will provide all documents and coordinate specified meetings required by the consultant to undertake the assignment as detailed in the implementation plan |
| INTELLECTUAL PROPERTY | All information obtained during the delivery of this Consultancy is the property of the Ministry of Health and Wellness and requests to use same must be made in writing to the Permanent Secretary |
6.0 Qualifications
Interested entities must satisfy the following requirements:
- The organization must be registered with the Company’s Office of Jamaica and/or the Department of Corporate and Friendly Society.
- Possess a valid Tax Compliance Certificate (TCC) and/or Tax Compliance Letter (TCL)
- Submit an application letter and an outline of the organization’s prospectus detailing their work in the area of HIV or related interventions. The document should detail:
- At least 3 projects successfully implemented in any social intervention area
- At least 2 projects implemented in HIV/STI interventions in the last 5 years
- At least 1 project successfully implemented in the last 2 years targeting prevention strategies in the key populations
- Must have procedures in place that maintains client’s confidentiality that is consistent with the delivery of these services. Inspection of facilities may be required.
- The organization is expected to have in place appropriate financial and project management systems.
Key Staff
The firm will be required to present in their proposal the following key staff for the implementation period of the contract:
| Key Staff | Number | Qualification |
| Programme Director | 1 | · post graduate degree (Masters) in Public Health, Public Administration, Business Management or related discipline
· Must have 5-7 years’ experience in providing the required services and support staff with at least 2 years’ experience. · At least 3 years’ experience in the management of programmes/projects · At least 2 years’ experience in managing HIV/STI prevention projects for the identified key populations Certification in Project Management or proven track record in project management would be an asset. |
| Field Coordinators | 4 (1 per Health Region) | · BSc in Social Sciences
· At least 5 years’ experience in the design and implementation of HIV related projects · At least 2 years’ experience working with at least one of the key populations that have been identified · At least 2 years’ experience in the supervision of field activities |
| Behavior Change Communication Specialist | 1 | · BSc in Social Sciences
· At least 5 years’ experience in the design and implementation of HIV related projects and leading interventions for BCC · At least 2 years’ experience working with at least one of the key populations that have been identified
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7.0 Key Deliverables
| Deliverable | Definition | Date for Delivery | % |
| Inception report | This report will give information:
· Work plan for the implementation of the project; · Proposed schedule of delivery for each subsequent deliverable; · Risk assessment for the project with the required mitigation strategies |
2 weeks after contract signing | 5% |
| HIV/STI Strategy | As defined in the Scope of Work | To be determine in inception report. | 10% |
| Monitoring and Evaluation Programme Document | As defined in the Scope of Work | To be determine in inception report. | 10% |
| Implementation Plan | As defined in the Scope of Work | To be determine in inception report. | 10% |
| Monthly progress reports | Progress Reports summarizing:
– the progress made during the period (planned vs. – actual targets, etc.) – the proposed activities for the ensuing month, – risks, challenges, gaps, and recommendations for addressing them – adjustments to be made to project plans as required |
10 working days after the end of the previous month | 50% |
| Final Report | The report will
Document challenges and mitigating strategies Detail recommendations, evaluation of the project implementation. (This must be benchmarked against the agreed Project Plan.) Propose strategies for further improvements in interventions |
10 working days after the end of project implementation | 15% |
8.0 Special considerations
- The organization will deliver a defined package of prevention services pertaining to STI infections, sexual and reproductive health and behavior change communications. The work will be executed under the technical guidance of the National Family Planning Board
- The executing organization will adhere to all national guidelines (current or those that will be developed during the period of contract execution) for the delivery of HIV/AIDS services. These will include, but not be limited to the Public Procurement Act (2015 and 2018)
- The participating entity shall client records and other documents that may be required by MOHW as evidence of services provided. MOHW reserve the right to delay payments if such documentation is not maintained and provided upon request for verification.
9.0 Payment
Payment shall be based on the agreed performance targets and the submission of the requisite financial and narrative reports.