TITLE: Technical Advisory & Support: Vaccination data management for COVID-19 vaccination introduction (short-term COVID-19 response) and strengthening immunization program registries and data management (long-term) in selected countries

BACKGROUND

Most PICTs in the South Pacific rely on traditional methods and paper or paper-electronic hybrid systems for measuring vaccination coverage, which can result in delayed information gathering for outbreak response. Extracting from paper-based records and transferring it to electronic records is time consuming and leads to delays in the availability of information, especially during outbreaks. Administrative coverage data are commonly used to assess coverage of mass vaccination campaigns.

Effective national implementation of COVID-19 vaccination will depend on the ability to access, receive and share information rapidly between managers and staff at all levels. To enable comprehensive decision-making, information from different data sources linked to COVID-19 such as local epidemiology, vaccination preparedness, performance and coverage monitoring, vaccine and supply management, vaccine safety and immunization waste management should be collected, analysed and disseminated. For most COVID-19 vaccine products, two doses of vaccine likely separated by 21 or 28 days, will be needed. Because different COVID-19 vaccine products will not be interchangeable, a vaccine recipient’s second dose must be from the same manufacturer as their first dose.  The real-time monitoring of uptake, safety and effectiveness of COVID-19 vaccines would benefit from use of electronic information platforms; however, in some Pacific islands contexts appropriate paper-based or partially digitized systems may be preferable. 

The Pacific COVID-19 Joint Incident Management Team (JIMT) and its COVID-19 vaccination taskforce is supporting the overall COVID-19 vaccination roll-out across the Pacific and looking for providing support for the countries to advance their planning horizons to introduce this new vaccine and identify key components (including information systems and monitoring) to strengthen as preparation for vaccination against this pandemic. Moreover, building and leveraging the COVID-19 vaccination introduction, the longer-term objective is to strengthen national immunization programs by building and strengthening electronic immunization information systems.  This component will focus on five Pacific island countries.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

Under the supervision of the Joint IMT, Technical Officer, Health Information jointly with WHO country offices the consultant will have the following specific responsibilities under two separate phases:

1. Short-term (emergency) support for systematic and tailored introduction of COVID-19 vaccine with a focus on data management and monitoring in the Pacific Island Countries as a key element of the COVID-19 response.  
   1. Assess the capability of national immunization programs to meet regional and country-specific COVID-19 vaccination reporting requirements
   2. Assess current systems and practices for vaccine data management including mass vaccination campaign management and patient reminder/recall in existing healthcare provider organizations to follow-up patients
   3. Define essential data and indicators needed to monitor immunization performance, standardizing the reporting formats and establishing information flow and procedures for all levels
   4. Review the existing national information management systems and determine their usability for COVID-19 vaccination data management including any additional needs
   5. Identify required modifications, ahead of time, in the existing data collection and monitoring platforms, or developing a dedicated system, based on defined standard requirements, if no such system exists
   6. Support the introduction of an electronic tool, paper-based or partially digitized system, for capturing and monitoring COVID-19 vaccination roll-out, if no such system exists
   7. Assess ICT capacity including connectivity problems or challenges in each country’s immunization data reporting or HIS system. Countries should ensure their immunization management infrastructure/tools meets COVID-19 response data exchange, storage, and reporting requirements
   8. Develop an implementation road map for COVID-19 vaccine administration documentation, data collection, management and reporting.
2. Planning to support strengthening the development of a framework for longer-term introduction and use of electronic immunization records/electronic immunization information system in the Pacific based on assessments of the current operational environment.
   1. Focus on five countries that are in the process of planning establishing electronic immunization record/immunization information systems
   2. Develop an implementation road map for strengthening countries overall vaccination data management, registries and reporting including new vaccine introduction data management

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

A) SHORT-TERM/EMERGENCY: VACCINATION DATA MANAGEMENT FOR COVID-19

There are opportunities to leverage the existing digital infrastructure and/or establish simple mobile based tools to manage immunization data in an electronic format, also for COVID-19 vaccination introduction. Digital tools could help with the monitoring of vaccine use, its availability at health facilities, and the recording of adverse events following immunization and many more. Readiness for and feasibility of any digital tools should be assessed, and results used to plan for an effective and feasible implementation approach (potentially having also paper-digital hybrid data management systems).

DELIVERABLES (11 countries)

1. Situation and feasibility analysis (foundations, readiness and maturity to adopt different tools for immunization data management)
2. Characteristics and implementation status of existing electronic information systems that could potentially support data management and other tools and/or with which integration/interoperability should be considered.
3. Identification of critical areas such as availability of IT infrastructure to support EIR/other tools from health facility to central level, mobile coverage, basic computer literacy of health staff, and capacity for system maintenance, including skilled human resources and funds, needs for technical assistance etc.
4. Identification of key stakeholders that should be involved in the development of functional and technical requirements, governance and implementation of immunization information systems and campaign data management.
5. Assess the existing laws, policies, and requirements that support development and operation of health information systems including standards and policies for data security and confidentiality.
6. Assess the capability of immunisation programs to meet regional and country-specific COVID-19 vaccination reporting requirements:
   1. Priority management eligibility: Collaborate with Joint IMT to implement a governance mechanism for prioritized populations (plan for authentication, onboarding and prepare/prepopulate data for different tools/settings)
   2. Monitor uptake among target population: subnational, national, and global monitoring of vaccine uptake will be essential to manage the roll-out of COVID-19 vaccination and reduce COVID-19 transmission
   3. Ability to track the administration of two doses of vaccine and generate second-dose reminders for vaccine recipients to ensure adherence with vaccine dosing intervals and achieve optimal vaccine effectiveness
   4. Ability to report certain data elements for each dose administered within 24 hours of administration
   5. Ability to provide proof of vaccination either in the form of a secure COVID-19 vaccination certificate (digital or paper based).
7. Design data management strategy and information system road map to evaluate immunity and coverage of COVID-19 vaccination to the most detailed level possible (neighbourhood, community, individual).
8. Apply technologies that facilitate data collection and warehousing in real time (or near real-time) and guide the implementation of these technologies during public health emergencies.
   1. Issue recommendations of ideal scope and requirements for COVID-19 vaccination data management and monitoring in the Pacific context.
   2. Conduct market scan and provide possible suitable technical solutions including product development by international agencies such as WHO, ADB, World Economic Forum.
   3. Assess feasibility to leverage and use existing infrastructure and tools (EIRs, EMRs, mobile data collection platforms, data warehousing) for COVID-19 vaccination data management and reporting.
   4. Collaborate with potential vendors in areas such as proof of concept, product deployment and implementation plan.
9. Update existing registries, vaccination card by risk group, and standardization of data reporting.
10. Training and human resources
    1. Determine the type of training required for different audiences, virtual platforms, and mechanisms for supervision, evaluation, accreditation, and monitoring.
    2. Develop national training plan with immunisation program and potentially with vendor collaboration covering:
    3.  Training content for data management, coverage reporting for severe adverse events following immunisation reporting, and operational implementation of the tools.
    4. Develop training materials for use in different virtual platforms (potentially with vendor collaboration)
11. Define the project timeline for each country.

B)  LONGER-TERM VACCINATION DATA MANAGEMENT FOR THE ROUTINE IMMUNISATION PROGRAM IN SELECTED PACIFIC ISLAND COUNTRIES

In the Pacific, there are multiple initiatives to improve routine immunization information systems by several countries and agencies.  The Asian Development Bank supports a comprehensive vaccination program for the introduction of the HPV, PCV and rotavirus vaccines in Vanuatu, Tuvalu, Tonga and Samoa. WHO have been supporting or planning the development of the EIRs in Samoa, Vanuatu and Solomon Islands.

However, several factors should be carefully considered before deciding to implement any digital tools including an EIR, such as: immunization program needs, ideal functional requirements (for COVID-19 campaigns specifically and routine immunizations separately), available IT infrastructures, costs of development, set up and maintenance of an EIR system, availability of trained human resources to manage and use the system, governance mechanisms and capacity to ensure EIR sustainability. The selection of most suited software/technical solution should be based on analysis of existing platforms and long-term eHealth/digital health country plans. Often it is assumed that existing systems would be readily found that would meet the requirements for an immunization registry. However, this was not always the case and the different software platforms should be reviewed in the work to finally arrive at the best solutions.

DELIVERABLES (Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu)

1. Assess the capability of immunization programs to meet regional and country-specific vaccination reporting requirements including the introduction of the HPV, PCV and rotavirus vaccines into four health systems (Tuvalu, Vanuatu, Samoa and Tonga).
2. Develop an implementation road map for strengthening countries’ overall vaccination data management, registries and reporting including new vaccine introduction data management.
3. Issue recommendations of ideal scope and requirements for the EIR in the Pacific country context and possible suitable technical solutions
   1. Investigate possible integration or interoperability of EIR with the national integrated health management information system (DHIS2) and other systems (e.g. Surveillance, supply chains, birth registration systems, EMRs, etc.)
   2. Leverage the work outcomes from the stage 1 on COVID-19 data management
4. Collaborate with potential vendors to understand high level feasibility and availability (i.e. costs, availability, timeframe, long-term technical support and maintenance plans, training and change management)
5. Define high-level timeline for the project implementation.

METHODS TO CARRY OUT THE ACTIVITY

Working with the telehealth working group, the case management cell, and the essential service delivery cell under the Health Operations Pillar of the JIMT, the consultant(s) will:

• • Organize and participate in relevant planning and consultation meetings
• • Lead the development of relevant guidelines and information products
• • Undertake desk reviews and interviews of key informants
• • Develop implementation timetable for the program of work
• • Provide direct technical advice and inputs covering all the relevant domains
• • Produce scheduled updates and monitoring reports
• • Collaborate with vendors to develop implementation plans and technology deployments

This work could be done by a single consultant or a team of consultants working concurrently on the various aspects of the Terms of Reference in a streamlined manner.

QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential:  Degree in medicine, public health, epidemiology, health information management or a related field

Desirable: Advanced degree in health informatics.

EXPERIENCE

Essential:

• • Understanding of the digital health and HIS including:
  • Immunization data management systems and campaigns
  • Unique health identifiers and biometric use in developing countries and/or internationally
  • Interoperability and standards, including health information exchange
  • Blockchain technologies
• • Previous experience on health services delivery and digital health in small countries/populations in remote and low resources settings.
• • Previous experience with similar work on EIR, immunization information systems and data management products (especially DHIS2, EMRs, mobile data collection and reporting tools) and surveillance.
• • Experience working with multiple government sectors.
• • Track record working on regional and multi-country initiatives.
• • Experience with small remote communities and islands settings such as the Pacific region.

Desirable:

• • Understanding of regional cooperation mechanisms and immunization programs.
• • Understanding international health regulations and border management.

TECHNICAL SKILLS & KNOWLEDGE

• • Broad understanding of digital health infrastructure (e.g. data centre, networks, hardware) and application services.
• • Familiarity with industry standard approaches and standards for health information exchange and interoperability.
• • Solid understanding of regulatory issues of technology and their impact across government and the country.
• • In-depth knowledge of external services provisioning arrangements, including outsourcing, health systems especially health service management.
• • Solid track record of bringing stakeholders from various groups in the health sector, across government and amongst development agencies.
• • Strong critical thinking, writing and presentation skills.

LANGUAGES  

Excellent knowledge of English is essential

COMPETENCIES

1. Teamwork
2. Respecting and promoting individual and cultural differences
3. Communication
4. Promoting WHO’s position in health leadership
5. Ensuring the effective use of resources

The contractor should have demonstrated track record working remotely.

ADDITIONAL INFORMATION

• Starting Date: December 2020
• Contract Duration: 8 months

APPLICATIONS

Qualified and interested specialists should submit their CV {for individual contractors} or Company Profile {for institutional applications} and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 3 January 2021. 

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and total cost estimate for the entire project (disaggregate between phases) and availability.

Please use Tender Notice No. 119774 as subject to all submission. Only successful candidates will be contacted