Terms of Reference (TOR) to Conduct Laboratory Training for Health Workers in Sahil Region, Somaliland
 
Reference: EPHS Lab Training
 
Deadline for submission of proposals: Friday, 7th June 2013
 
Health Poverty Action-HPA
 (formerly known as Health Unlimited) is a British NGO, which aims to 
create a world in which the most vulnerable communities can enjoy their 
rights to health and well-being. 
We give priority to the most excluded and, in particular, indigenous people and
communities affected by conflict and political instability.
 
communities affected by conflict and political instability.
HPA under the financial 
support of DFID through the Health Consortium Somalia (HCS) is 
implementing a Maternal and Child Health programme piloting the 
‘Essential Packages of Health Services (EPHS) in Sahil Region of 
Somaliland.
 
This is a comprehensive 
program with interventions ranging from human resources for health, 
building institutional capability of health facilities to provision of 
support to referrals and medical supplies and equipment.
 
Sahil Region – The Context
 
The Sahil Region 
(Saaxil), one of the six administrative regions of Somaliland shares 
boundaries with The Gulf of Eden and Maroodi Jeex, Sanaag, Togdheer and 
Awdal regions.
 
Although the capital 
Berbera is a modern town with urban characteristics, majority of the 
population live in rural areas with agro-pastoralists and nomadic 
lifestyles. Difficult geographic terrains and a hot harsh weather 
characterize Sahil. Harmful traditional practices such as FGM and GBV 
are common. It has the highest HIV prevalence in Somaliland with no 
adequate VCT facilities.
 
HPA under the current 
program covers the entire Sahil region with 4 referral health centres, 6
 health centres 15 primary health care units and Berbera (regional) 
hospital. 
Since commencement of HPA support, all the 4-tiers of health facilities are now fully operational in the region.
The Primary health care 
unit (lowest level of health service staffed by Community Health 
Worker-CHW) provides basic health services to community. 
The PHUs play a role of 
providing basic services and health education, and informing upper level
 facilities if there are any obstetric patients or where specialized 
care is required. TBAs and Community Health Committee support to CHW in 
PHU level.
 
The second level is the 
Health Centre. This facility is staffed by two qualified nurses, one 
midwife, two auxiliaries, one health aid, cleaner and watchman. This 
facility provides basic emergency obstetric care (BEOC) and other 
general health services such as OPD, ANC/PNC, health education, 
nutrition and pharmacy.
 
All complicated cases, if
 they receive are referred to the Referral Health Centre or Berbera 
hospital. HPA and MOH have provided 7 ambulances stationed in the RHCs 
and Berbera hospital to support emergency services. The Referral Health 
Centres provide BEOC/CEOC (CEOC service are expected to start soon) and 
other services such as services OPD, ANC/PNC, health education, 
nutrition, pharmacy, ambulance and laboratory. 
This facility is staffed 
by Clinical officer (Incharge), four qualified nurses, three midwives, 
one laboratory technician, one auxiliary, two health aids, two cleaners 
and two guards. This facility provides 24/7 services.
Berbera hospital is the final referral point in Sahil region providing specialised services such as CEOC, assisted delivery, child health, Nutrition, TB, mental health, x-ray, ultrasound, ECG, laboratory, VCT etc.
 
Berbera hospital is the final referral point in Sahil region providing specialised services such as CEOC, assisted delivery, child health, Nutrition, TB, mental health, x-ray, ultrasound, ECG, laboratory, VCT etc.
Laboratory needs
 
HPA has supports the 
infrastructural establishment of the health system in the region. In the
 referral health centres it has established fully equipped operating 
theatre rooms, maternity wards and laboratory rooms to support 
diagnosis. Proper diagnosis of most health cases depends on laboratory 
services, examination and report. Accessible, high-quality laboratory 
services are critical to the deliver quality health services. 
They provide support for 
the day to day routines of diagnosing illnesses presented by patients, 
disease surveillance activities, assessment of the adequacy of treatment
 for infectious and chronic diseases, and development of more sensitive 
methods for the detection of preventable illnesses.
 
Sahil is a challenging terrain with harsh weather patterns. 
As a result, it attracts relatively youthful health workforce. 
Laboratory technicians 
working in referral health centres for instance are fresh graduates 
locally trained in Somaliland institutions. 
They don’t have any practical skills or training on laboratory. 
In Berbera hospital, 
there are 10 staffs of technician and assistant in laboratory unit 
(General laboratory, HIV, TB and Blood Bank). 
However they have not had
 continuing professional development related to improved laboratory 
skills other than blood banking and transfusion (2011), HIV counselling 
(2012) and chemical & biohazard safety training (2013).
 
They have many modern 
laboratory equipment supported by agencies and also donated by diaspora 
Somali groups and other therefore remain non-functional, due to the lack
 of operation skills. 
HPA in light of this gap 
is putting up efforts to revitalise human resources in laboratory 
sections of the hospital and RHCs through practical training and skills 
improvement.
 
This TOR development is a
 result of consultative efforts and request by the regional health 
office for skills support in laboratory field.
 
Main Objective: To improve clinical laboratory skills on major tests of 15 staffs of Berbera hospital and four-referral health centres of Sahil.
 
Specific Objectives
 
The training will seek to fulfill the following objectives:
- Relate the role of the clinical laboratory to the total patient care and enhance professional ownership and accountability.
- Demonstrate a theoretical understanding of the major basic laboratory tests, most specialized laboratory testing and some esoteric laboratory testing.
- Review current knowledge and make clinical decisions regarding the correlation of patient results, validity of those results and the need for additional testing.
- Demonstrate proficiency by discussing, interpreting and utilizing quality control methods to maintain laboratory accuracy and precision.
- Apply established quality assurance practices in respect to patient care
- Perform preventative and corrective maintenance on laboratory instrumentation and recognize when to refer repairs to the appropriately trained source.
- Provide an understanding on managing lab supplies chain
- Patient and staff safety procedures and proper management of lab waste
- Record keeping and reporting of lab activities
Deliverables:
- Submit a protocol and tools for the skills assessment
- Carry out the laboratory skills assessment of both Hospital and Referral Health Centre’s laboratory technicians and set up the three level of training i.e. Basic level, intermediate level (six months later) and advance level (one year later)
- Develop laboratory training protocol and materials including handouts and presentations
- Prepare a report on the training including outcomes, with pragmatic future steps and certification
Time Frame
 
Total duration of this 
assignment will be 20 days (10 days basic level, 5 days intermediate 
level and 5 days advance level) in field training. 
Preparation, travel days and report duration will be negotiable.
 
Supervision: The consultant (trainer) will work under the supervision of the programme manager in consultation with the APM.
Proposal submission
Qualified consultants/firms are invited to submit technical and financial proposals to consultancies@healthunlimited.or.ke
Please indicate the reference, EPHS Lab Training, of the Call for Consultancy in the e-mail subject line.
 
The deadline for submission of technical and financial proposals is on Friday, 7th June 2013






 
 
 


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