1 | P a g e
TERMS OF REFERENCE
for the Baseline Study
of the
Prevention and control non communicable diseases (Diabetes &
Hypertension) in Imenti South Sub County, Meru County
Implemented by the Kenya Red Cross Society in collaboration with MOH and
County Government of Meru
Funded by: Danish Red Cross,
Date of this terms of Reference (12th June 2019)
2 | P a g e
1. Summary
1.1. Purpose: The primary purpose of the baseline study is to describe the current status
of Non communicable diseases (NCD) and levels of access to critical NCD services in
the targeted communities in Imenti South Sub County, Meru County. The baseline
will provide benchmark statistics against the programme indicators, against which
programme progress, perfomance and impact will be gauged.
1.2. Partners: Kenya Red Cross Society and Danish Red Cross
1.3. Duration: 30 days
1.4. Estimated Dates: 8th July 2019 to 6th August 2019
1.5. Geographical Location: Imenti South Sub County, Meru County
1.6. Target Population: Population of 179,604 which includes Community members and
stakeholders within targeted locations, project staff.
1.7. Deliverables: Inception report and tools shared and presented, first and second
drafts and final report plus all data sets.
1.8. Methodology: Cross sectional study triangulated by qualitative methodologies
1.9. Baseline Study Management Team: KRCS M&E and program representatives, and
PNS representative
2. Background Information
Project Objectives
The overall objective is to contribute to reduction of the preventable burden, morbidity,
mortality and costs due to Non-communicable diseases and promote the well-being of the
Kenyan population by providing evidence based NCD prevention and control interventions
in order to ensure optimal health throughout the life course for sustainable socioeconomic
development by the year 2025.
The immediate objective is to improve primary and secondary prevention of Non
communicable diseases (Diabetes and Hypertension) through strengthening of the
continuum of care and advocacy in Imenti South Sub-county, Meru County.
3 | P a g e
The specific objectives/outputs are to: (See annex 1 for results framework)
1. To increase NCD knowledge and practice of healthy lifestyles in Imenti Sub-County,
Meru County.
2. To improve early detection of NCD through introduction of NCD screening in the
existing health care system.
3. To enhance advocacy for NCD policies at the county and national level.
4. To build the capacity of MOH and KRCS at the county and national level on management
and implementation of NCD programs in Kenya.
The findings and the baseline data, contained in the Baseline Survey Report, will provide a
starting point for the program and the basis by which performance, progress, achievement
and impact will be measured during and after the project life. As well, the findings will
enable the project team to review the project plans to ensure that they have realistic and
evidence based targets, strategies and timeframes in lieu of the objectives and indicators.
The programme will be implemented in close coordination with the MoH at National and
County Level and with the involvement of the communities at the sub county level as the
programme objectives are in line with the Sub County Annual Operational Plans, thus
making the MoH a strategic stakeholder in the programme. In addition, the programme is
supporting the implementation of the Community Health Strategy, which is major priority
for the MoH. The MoH hosts coordination meetings with other health stakeholders in
Nairobi, a forum in which the KRCS is represented.
At the community level, the programme will be implemented by community health
volunteers supervised by the CHCs with links to the health system. The programme staff will
work closely and coordinate with the volunteers, committees and the relevant MoH staff.
4 | P a g e
3. Study Purpose & Scope
3.1 Purpose: State the broad and specific objectives
The study aims to establish baseline information against the projects agreed indicators
which will be used as a threshold for this project to assess impact. This should include a KAP
survey that establishes the baseline on the indicators set for knowledge, attitude and
practice. The specific objectives of the baseline study be to:
1. Examine the current knowledge levels, Attitude and practices of the targeted
populations concerning the NCDs of interest.
2. To establish level of NCD service provision and uptake at the community level.
3. To generate the benchmark values of all the log frame indicators.
4. To determine the current level of implementation of NCD policies and plans by the
health authorities at the county and national government levels.
5. Examine community preferable approaches of engagement in relation to their
participation in the project and feedback mechanism.
4. Study criteria and Key questions
Baseline values: What is the current coverage of the log frame outcome indicators?
Relevance:
o Does the community realize the need for the project?
o How relevant will the interventions be to county/national government
priorities
Expected Outcomes: What will be the anticipated changes? Whether positive or
negative?
Gender and disability mainstreaming: To what extent should gender equity and
disability mainstreaming issues be integrated throughout the project cycle?
Sustainability: What measures should be put in place to ensure sustainability of the
project (consider institutional, environmental, financial, socio cultural)
Community Engagement and Accountability
5 | P a g e
o How would the community wish to be involved in the project?
o To what extent is the Community Engagement and Accountability (CEA)
integrated in the project design?
o How can Community Engagement and Accountability best be put in place in
the project design, to:
Ensure that the project set-up take into account the changing
community needs and risks in their political, social, economic and
physical contexts
Ensure that the communities understand the project and all its
systems and are up to date with project implementation status and
plans.
Ensure communities participate in the project decision making.
5. Study Methodology
The Baseline Study shall employ the cross sectional study design where quantitative,
qualitative and spatial methodologies will be used to reach its findings. For every indicator,
every quantitative piece of data must be qualified by its corresponding qualitative and
spatial data. That means that the study, especially for the qualitative aspect must employ
participatory methodologies and also try to link the health challenge and solution to their
physical environment and geographical area to the location level. Quantitative data must be
collected using mobile phones.
6. Study Quality & Ethical Standards
The consultant shall take all reasonable steps to ensure that the study is designed and
conducted to respect and protect the rights and welfare of the people and communities
involved and to ensure that the study is technically accurate and reliable, is conducted in a
transparent and impartial manner, and contributes to organizational learning and
accountability. Therefore, the study team shall be required to adhere to the study standards
and applicable practices as recommended by International Federation of Red Cross and Red
Crescent Societies.
6 | P a g e
Utility: Study must be useful and used.
Feasibility: Study must be realistic, diplomatic, and managed in a sensible, cost
effective manner.
Ethics & Legality: Study must be conducted in an ethical and legal manner, with
particular regard for the welfare of those involved in and affected by the study.
Impartiality & Independence; Study should be impartial, providing a comprehensive
and unbiased study that takes into account the views of all stakeholders.
Transparency: Study activities should reflect an attitude of openness and
transparency.
Accuracy: Study should be technically accurate, providing sufficient information
about the data collection, analysis, and interpretation methods so that its worth or
merit can be determined.
Participation: Stakeholders should be consulted and meaningfully involved in the
study process when feasible and appropriate.
Collaboration: Collaboration between key operating partners in the study process
improves the legitimacy and utility of the study.
It is also expected that the study will respect the seven Fundamental Principles of the Red
Cross and Red Crescent: 1) humanity, 2) impartiality, 3) neutrality, 4) independence, 5)
voluntary service, 6) unity, and 7) universality.
7. Qualifications and Experience for Consultants
The lead consultant must possess the following qualifications:
1. A master’s degree in Public Health.
2. Proven experience in NCD programming and evaluations.
3. Must have led in at least five participatory studies. Experience of conducting
baselines and working in the target or similar communities (preferred)
4. High level of professionalism and an ability to work independently and in high-
pressure situations under tight deadlines.
7 | P a g e
5. Strong interpersonal and communication skills
6. The team must have a statistician familiar with SPSS for data management.
7. Firm must have experience in using mobile phone technology for data collection,
monitoring and reporting
8. The lead consultant must have strong analytical skills and ability to clearly synthesize
and present findings, draw practical conclusions, make key recommendations and to
prepare well-written reports in a timely manner.
9. Availability for the period indicated.
8. Management of the Baseline Study
Duration: The Baseline Study shall be conducted for 30 working days to be completed by
mid-July 2019.
Deliverables:
1. Inception report detailing the Baseline Study design, sampling methodology & survey
tools, agreed budget and work plan.
2. Draft Baseline Study Report and all raw data.
3. A power point presentation highlighting key findings from the baseline will be
presented at a feedback meeting at HQ to be held after completing the draft report
4. Dissemination and validation presentation to the County Stakeholders teams.
5. Final Baseline Survey Reports.
6. Copies of original and cleaned data sets with codebook. The raw data, the database
which has been cleaned (both qualitative and quantitative, including original field
notes for in-depth interviews and focus group discussions, as well as recorded audio
material), should be submitted together with the report. A simple inventory of
material handed over will be part of the record. KRCS & DRC will have sole
ownership of all final data and any findings shall only be shared or reproduced with
the permission of KRCS.
Evaluation Management Team: The evaluation management team shall consist of KRCS
MEA&L Unit Representative, KRCS NCD Program Manager, Danish Red Cross Representative
8 | P a g e
as well as the Meru County MoH Representative. They shall ensure that the deliverables
agreed upon and approved in the inception report are achieved on time.
Role of KRCS (project and MEA&L team)
Lead the recruitment and evaluation process.
Coordinate the evaluation implementation process through the KRCS M&E unit.
Review of evaluation products including the log frame, tools and reports.
KRCS will organize logistics for the evaluation team.
Avail data collectors within agreed criteria.
Avail all necessary documents for desk review.
KRCS will be the link between the community, donor and the consultant
Will be the custodian of all data generated from the study
Organize dissemination forums as necessary
Role of Danish Red Cross
Participate in the TOR development and recruitment process
Review and give feedback on all baseline products
Fund the activity budget
Final approval of the report
9. Application Requirements
To apply, the consultant shall prepare in writing both technical and financial proposals and
submit them adhering to the outline in annex 1. The financial proposal MUST BE SENT IN A
SEPARATE ENVELOP FROM THE TECHNICAL PROPOSAL.
Please also note that the people whose names appear in the team composition template
MUST be the ones to undertake the study. As such, they MUST be the ones to appear in
person if the proposal moves to the interview stage.
Failure to adhere to any of these requirements will lead to automatic disqualification or
breach of contract if the work has begun.
9 | P a g e
Kenya Red Cross Society reserves the right to cancel the contract if, convinced that the
consultant is in breach of the terms and conditions including those approved in the
inception report.
10. Submission of proposal
The technical and financial proposals addressed to the Chairperson, tender committee,
Kenya Red Cross Society, P.O Box 40712-00100 Nairobi should be submitted by 26th June
2019 at 12noon.
The Technical Proposal MUST comply with the outline provided in Annex 1 while the
financial proposal shall conform to the template provided in Annex 2. Team
composition should conform to Annex 3
Bidders should provide a technical and financial proposal in two separate envelopes
clearly marked “Technical Proposal” and “Financial Proposal” and sealed in one plain
envelope clearly marked “Tender No. PRF05203 “Call for Consultancy for Baseline
“Prevention and Control of NCDs for Healthy Lifestyle Project
ANNEX 1: TECHNICAL PROPOSAL FOMART
1) Introduction: description of the firm, the firm’s qualifications and statutory compliance
(1 page)
2) Back ground: Understanding of the project, context and requirements for services, Key
questions (2 pages)
3) Proposed methodology - Indicate methods to be used for each indicator and highlight
any areas where indicators may need adjustment. The targeted respondents should be
indicated for each indicator. Proposed detailed questions should be indicated. Detailed
sampling procedure needs to be indicated. (5 pages)
4) Firms experience in undertaking assignments of similar nature and experience from the
geographical area for other major clients (Table with: Name of organization, name of
assignment, duration of assignment (Dates), reference person contacts-2 pages
10 | P a g e
5) Proposed team composition (As per annex 3)-1 page
6) Work plan (Gantt chart of activity and week of implementation)-1 page
NB: Evidence of past reports done and statutory documents to be availed during the oral
phase.
ANNEX 2: BUDGET TEMPLATE
The consultant shall only quote for the items below as KRCS will manage all other related
costs (Logistics and payment of enumerators)
Item Unit # of
Units
Unit
Cost Total Cost (Ksh.)
Consultancy Fee (for the whole study
period)
Per day
Office expenses (Printing, photocopy,
binding, communication costs etc.)
lump sum
Grand Total
ANNEX 3: PROPOSED TEAM COMPOSITION TEMPLATE
Name of Team Member Highest Level of
Qualification
General Years of
Experience related
to the task at
hand
Roles under this
assignment
11 | P a g e
ANNEX 4: TENDER STUDY CRITERIA
A three stage study procedure will be used to evaluate all proposals from bidders. The total
number of points which each bidder may obtain for its proposal is:
Technical Proposal 60 marks
Oral presentation 30 marks
Financial Proposal 10 marks
1. Study of the Technical Proposal
The technical proposal shall be evaluated on the basis of its responsiveness to the TOR.
Specifically, the following criteria shall apply:
Study Criteria Maximum
Points
Possible
Bidders
score
Remarks
(1) Introduction:
Description of the Firm and the Firm’s
Qualifications
Detail of Legal Compliance
5
(2) Background : Understanding of the project,
context and requirements for services
10
(3) Proposed Methodology: The proposed
methodology MUST provide an indication of its
effectiveness and added value in the proposed
assignment.
20
(4) Firms Experience in undertaking assignments
of similar nature and experience from related
geographical area for other major clients
Provide a summary and supporting
information on overall years of experience,
and related technical and geographic
coverage experience.
10
12 | P a g e
(5) Proposed Team Composition:
Tabulate the team composition to include
the general qualifications, suitability for the
specific task to be assigned and overall
years of relevant experience to the
proposed assignment.
The proposed team composition should
balance effectively with the necessary skills
and competencies required to undertake
the proposed assignment.
Lead Consultant Qualifications – should be
as per the TOR
Mandatory-statistician
10
(6) Work Plan: A Detailed logical, weekly work plan
for the assignment MUST be provided.
5
TOTAL SCORE 60
Total scores of the technical bid analysis shall be converted to a denominator of 60. Top
three firms will go to the orals and financial review stage. If we get only three bids, then
they all go to the oral stage and financials.
Name of Consultant
Criteria Score Remarks
Understanding of the assignment
(5 Marks)
Clear and scientific methodology
(15 Marks)
13 | P a g e
Presentation of
Detailed CVs of team to be involved
Evidence of legal Compliance-
Registration, PIN certificate, tax
compliance etc.)
two Sample reports of previous
assignments
(5 marks)
Referee’s’ feedback (5 Marks)
2. Study of the Financial Proposal
The Financial Proposal shall be prepared in accordance to Annex 2. The maximum number
of points for the Financial Proposal shall be 10% (10 points). This maximum number of
points will be allocated to the lowest Financial Proposal. All other Financial Proposals will
receive points in inverse proportion according to the below formula:
Points for the Financial Proposal being evaluated =
(Maximum number of points for the financial proposal) x (Lowest price)
Price of proposal being evaluated
A total score obtained including both Technical and Financial Proposals is calculated for each
proposal. The bid obtaining the overall highest score is the winning bid.
14 | P a g e
Annex 1: Results framework
Overall Objective: To contribute to reduction of the preventable burden, morbidity, mortality and costs
due to Non-communicable diseases and promote the well-being of the Kenyan population by providing
evidence based NCD prevention and control interventions in order to ensure optimal health throughout
the life course for sustainable socioeconomic development by the year 2025.
Immediate
Objective: To
improve primary
and secondary
prevention of Non
communicable
diseases (Diabetes
and Hypertension)
through
strengthening of
the continuum of
care and advocacy
in Imenti South
Sub-county, Meru
County
E1: % of target population 18+ years with
high BMI (defined as body mass index ≥ 25
kg/m² for overweight and body mass index ≥
30 kg/m² for obesity) disaggregated by age
and gender
Health
facility
records
1. There will be
adequate supply of
drugs, equipment,
staff and
consumables
throughout the life
of the project for
the relevant
activities. That is
there will be no
industrial action or
tarnsfers or other
dynamics that will
cause huge turnover
of health
workers/volunteers.
2. The Health
Management
Information System
(HMIS) is
functioning
adequately enough
to provide accurate,
complete, precise
timely and
verifiable data and
E2: % of target population 18+ years with
raised blood pressure(defined as systolic
blood pressure ≥140 mmHg and/or diastolic
blood pressure ≥90 mmHg) disaggregated by
age and gender
Health
facility
records
P1: #/% of target population that have gained
access to prevention, treatment and care
services through the project disaggregated by
type of service, gender and age
Evaluation
P2: # of target population 18+ with raised
blood pressure and/or high BMI
disaggregated by gender and age
Health
facility
records
E4: % of targeted population that have
received t MoH recommended routine NCD
tests
Health
facility
records
P3: # of target population reached by the
project disaggregated by gender and age
Activity
reports
Output 1: Increased
knowledge of
diabetes and
hypertension and
Practice of healthy
E1 % population aware of Risk Factors to
Diabetes and Hypertension and how to
prevent/manage them disaggregated by age,
gender, occupation and NCD status
Evaluation
E2% of target population with improved Evaluation
15 | P a g e
lifestyles in Imenti
South Sub-county
dietary practices /E3 % of target population
with improved physical activity practices
information for
decisions for the
project and its
results. This
includes adequate
tools for data
recording,
aggregation
summary and
analysis into the
DHIS as well as the
required SCHRIO.
3. The community
health units are
fully functional as
per the CHS
functionality
checklist.
4. Peace and
tranquility will
prevail in the sub
county and in
Kenya. That means
that there will be no
violent conflict and
its effects such as
population
movement among
others.
Process 2%3: # health workers trained in NCD
prevention and care aggregated by gender +
# of CHW trained in NCD prevention and care
aggregated by gender
Activity
reports
# of target population identified with risk
factors and referred for screening
Health
facility
records
P: # of community sessions on promotion of
healthy lifestyle implemented according to
plan
Activity
reports
Output 2:Improved
early detection,
screening and
diagnosis of
diabetes and
hypertension by
enhancing
integration of NCD
screening into
existing healthcare
systems
Process 3: Percentage of NCD patients seen
regularly at clinics e.g. Four times a year.
Health
facility
records
Process/End line: #% of target population
screened for BP and raised glycose
Facility
records
Process: # of patients in treatment for for an
NCD condition at the health facility
Facility
records
Process: Number of people who do regular
home monitoring of blood glucose and blood
pressure e.g. daily or weekly.
Evaluation
Output 3: Enhanced
Advocacy and
contribution to
policy for NCD
programming at
County and
National level
End line 1: % increase in funds allocation of
NCDs programmes by the county government
County
budget
End line 2: Level (%) of operationalizing of the
NCD strategies and policies as per the
planned timeliness.
Evaluation
Process 1: Number of adopted National NCD
policies, guidelines, strategies etc. adopted
by the target sub-county by type and target
group
Evaluation
16 | P a g e
Process 2: Number of goodwill ambassador
advocating for NCD programming in the
county
Evaluation 5. There will be no
largescale
emergencies that
may divert skills and
resources and
therefore slow
down the
achievement of
results.
Output 4: Enhanced
KRCS and MOH (at
sub county level)
capacity for NCD
management and
implementation
End line 1: Percentage of project objectives
that perform at over 91% of the set quarterly
and annual targets
Evaluation
End line 2: Proportion of the target
population receiving quality health care
services
Evaluation
Process 1: Number of the staff supported to
attend NCD related technical trainings and
conferences
Mission
Reports
Process 2: Number of new NCD partnerships
established
Signed
agreement
Output 5:Inspire
DRC partner
National Societies
in Africa to engage
in NCD
programming
focusing on
prevention and care
End line 1:% level participants who
understand the NCD burden and risk factors
as well as RCRC added value in this
workshop
evaluation
report
End line 2: % level of completion of NCD
programming plan of action for DRC in Africa
PoA
Process 1: Number of workshops conducted
to disseminate the NCD programming plan of
action for DRC in Africa.
Workshop
reports
Process 2: # of project concepts (2 pager)
developed and received seed funding to
start implementing in 2019
concepts
notes
