ToR Strengthening TB surveillance system

South Africa has one of the highest incidence rates of TB globally. Surveillance is a key component of the control program to ensure that the epidemiology of the disease is understood and effective strategies are implemented. In addition it is important to assess programmatic impact of interventions introduced or identify further needs.

South Africa has 3 electronic systems that are important sources of data: the Electronic TB Register (ETR), Electronic Drug Resistance Register (EDR) and the Corporate Data Warehouse (CDW) laboratory data. However, these systems need to be further improved to ensure that a robust system is available. In addition, merger of these databases are important to ensure that important gaps between diagnosis and treatment are monitored and closed.

The National Department of Health (TB cluster) and the National Institute for Communicable Diseases (Centre for TB) have established a collaborative initiative to address these needs. Thus far progress has been made in developing the CDW into a surveillance data source for TB. In addition the EDR which is housed as a single database has been further cleaned and de-duplicated as part of this initiative. Recently the CDW and EDR have been electronically linked and a field assessment of the data systems linkage is being evaluated. The findings will assist in improving the linkage further.

However, the component that is outstanding is the ETR data which needs to be harmonised, cleaned and de-duplicated. The challenge with the ETR is that it has been a fragmented system that has evolved over time and this has resulted in changes which have resulted in different datasets that have proven difficult to harmonise primarily due to the lack of a dedicated small team to focus on this task. This component needs to be completed in parallel with the other tasks to ensure that progress made on the other components are not delayed.

1.    Goal

The goal is to ensure that the 3 electronic systems used by the TB programme in South Africa as important sources of data are robust and could be linked: the Electronic TB Register (ETR), Electronic Drug Resistance Register (EDR) and the Corporate Data Warehouse (CDW) laboratory data. The completion of the tasks below is aimed at facilitating the merging of these databases and is important to ensure that critical gaps between case findings, diagnosis, linkages to care and treatment are adequately monitored.

2.    Objectives

The consultant is expected to work with the Research Information Monitoring Evaluation and Surveillance (RIMES) directorate of the National TB programme (NTP), National Institute for Communicable Diseases (Centre for TB) and WHO in carrying out the following specific tasks:

1. To supervise and manage a project for the ETR data cleaning, de-duplication of patient records, combination of provincial data from 2004 – 2013 to a single database from which analyses can be performed.
2. To establish and document a standardized process that will be applied subsequently for sustainability of the intervention
3. To build the capacity of the (NTP) staff in order to institutionalize the standardized process.
4. To provide support for basic analyses of data to determine TB rates per province and change in TB incidence over time.
5. To produce a final report that includes the processes followed, the criteria, final analyzable database, findings and implementable recommendations that will ensure the sustainability and routine practice of the NTP programme.

3.    Approach

The approach will include but not limited to:

• Supervision of the work of a statistician that has been seconded by Aurum Institute to support the project in line with the project objectives.
• Carrying out frequent joint consultations with the Research Information Monitoring Evaluation and Surveillance (RIMES) directorate of the National TB programme (NTP), National Institute for Communicable Diseases (Centre for TB) and WHO in the performance of these tasks. The frequency and mode of the consultation process will be decided at the inception meeting
• Clearly discuss criteria for the interventions during the consultation process

4.    Deliverables

1. Deliverable 1:
   Develop a robust workplan informed by the initial scope analysis in consultation with the Research Information Monitoring Evaluation and Surveillance (RIMES) directorate of the National TB programme (NTP), National Institute for Communicable Diseases (Centre for TB) and WHO
2. Deliverable 2:
   Generate the final database in consultation with the Research Information Monitoring Evaluation and Surveillance (RIMES) directorate of the National TB programme (NTP), National Institute for Communicable Diseases (Centre for TB) and WHO
3. Deliverable 3:
   A comprehensive report addressing all tasks under the five objectives outlined in this document with details on the processes followed, the criteria, findings and implementable recommendations.
4. Deliverable 4:
   A power point presentation on the final product

5.     Profile required

• A senior epidemiologist with extensive quantitative skills and a proven track record of producing results and communicating them well
• Excellent understanding of TB epidemiology and surveillance system
• Extensive experience in working with national TB health programmes and offering technical assistance

6.    Timeline and Budget distribution plan

The task is expected to start immediately after finalization of contract and run for not more than six weeks; the six weeks can be distributed over a maximum of six months because of the nature of the tasks involved.

1. 25% of the total budget will be paid at the completion of deliverable 1.
2. 25% of the total budget will be paid at the completion of the first deliverable 2
3. 50% of the total budget will be paid at the completion of the first deliverables 3 & 4

7.    Application

Interested service providers must submit to “afwcozahr@who.int”

• A concept note of not more than 10 pages
• A  budget and work plan

Curriculum Vitaes detailing previous related experience.

The Closing date for the application is 30 September, 2014. Late applications will not be considered. Correspondence will be limited to the selected candidates only.

9. Ownership of data

The National Department of Health (NDOH) retains the full ownership of the data that will be used for this project and all the products of the project. NDOH rules and regulations on data management must be adhered to in implementing this project. Clarity will be provided on data management by the NDOH at the inception meeting of the successful service provider.

10.Enquiries

Any further technical information regarding the assignment can be obtained by contacting Dr Sanni Babatunde (sannib@who.int)

WHO reserves the right NOT to select any service provider.