WASH in Health Care Facilities

Consultancy on Water, Sanitation and Hygiene (WASH)
in Health Care Facilities

1. SNV NETHERLANDS DEVELOPMENT ORGANISATION
SNV is an international not-for-profit development organisation that focuses on increasing people’s incomes and access to basic services in Water, Sanitation and Hygiene (WASH), Agriculture, and Renewable Energy. By connecting our global expertise with longstanding in-country presence, we help realise locally-owned solutions in more than 25 countries in Asia, Africa, and Latin America. Established in 1965 in the Netherlands, our projects directly benefit millions of people (4.4M in 2018). SNV specializes in supporting the resourcefulness of development actors by developing local capacities, improving performance and services, strengthening governance systems, helping to create access for excluded groups and by making markets work for the poor.

2. THE WASH SDGS FOR SUSTAINABLE AND INCLUSIVE CITIES PROGRAMME
SNV understands safe sanitation and hygiene services as a pre-condition for health and economic development in cities. With Indonesia’s urbanization rate at 2.3% (World Bank, 2018), a failure to invest in urban sanitation will become a barrier for almost any development in the country. Access to sanitation is a human right and governments are the duty bearers of progressive realisation of this right. With the Sustainable Development Goals (SDGs), notably SDG 6 and the 2020-2024 RPJMN, Indonesia is committed to work towards universal access to safely managed sanitation services, this means services for all and addressing the safety of the entire sanitation chain from access to safe disposal or re-use.

Through the Dutch Government funded WASH SDGs programme, SNV supports local governments of Bandar Lampung & Metro Cities in Lampung Province and Tasikmalaya City in West Java Province in achieving sustainable and inclusive city-wide sanitation services, in line with national programmes and targets. Together, we change the way human waste is managed by addressing different needs among the population, different parts of the sanitation service chain, and different geographical areas with appropriate service delivery models.

3. BACKGROUND
Indonesia still faces a number of challenges concerning the issues around Water Sanitation and Hygiene (WASH) in Health Care Facility (HCF). Indonesia accounts for the eighth largest number of neonatal deaths in the world[1]. According to the Ministry of Health’s national health survey[2], sepsis accounted for 12% and 21% of mortality of 0 - 6 days and 7 – 28 days age groups, respectively. Interventions such as handwashing and clean birth practices, in both homes and HCF, significantly reduce the risks of neonatal mortality[3]).

Despite the multiple regulatory tools issued by the Government of Indonesia, in particular the Ministry of Health (including UU36/2009 and PMK75/2014, PMK13/2015 and PMK46/2015, amongst others), a recent data analysis jointly conducted by the Government of Indonesia and UNICEF found that one quarter of primary health centres (23.6%) did not have access to a combination of minimum basic water and sanitation services with significant regional variation observed (10.6% – 59.8%)[4].

The importance of adequate WASH conditions in health facilities is well established and the need for its global improvement was further enhanced through the Sustainable Development Goals (SDGs). Through Presidential Decree 59/2017, Indonesia has committed with the achievement of the SDGs and dedicated Health Care facilities objectives are reflected in the forthcoming RPJMN 2020-2024. Further, the country has committed with conducting HC facilities surveys (ASPAK) and has started web-based data reporting on HCF, including on WASH conditions. A country baseline is to be established soon.

4. GENERAL OBJECTIVE
Through this consultancy, SNV’s WASH SDGs programme aims to assist the governments of Bandar Lampung, Metro and Tasikmalaya to improve WASH conditions in Health Care facilities, with the findings also aiming to support evidence based advocacy efforts at the national level.

5. SPECIFIC OBJECTIVES AND SCOPES OF CONSULTANCY WORK
The specific objectives and the scopes of the consultancy work are:

1.    To examine the comprehensiveness of the existing regulations and parameters for WASH in Health Care facilities in Indonesia, in comparison with the good practices established internationally. These should take as primary reference the JMP/WHO definitions of indicators for water, sanitation, hygiene, waste management and environmental cleaning as well as the national parameters as stated in RIFASKES and other relevant documents. A mapping of the existing gaps is to be provided.

2.    Using available data and collecting additional one with key stakeholders, examine the constraints preventing good conditions to be in place. Opportunities are also to be identified. This examination should include regulations, institutional arrangements, technical parameters, financial and human capacity, monitoring mechanisms and pay attention to issues of gender and social inclusion. 

3.    Based on the data and related analysis, develop a strategy to improve the WASH conditions in health facilities. The strategy is to have two levels: i) a high level, longer term strategy, targeting the elements that require improvement at the national level; ii) a localized strategy for each of the targeted cities, identifying short term, medium term and long term initiatives to improve WASH conditions in health care facilities

4.    Specifically for point 3.ii) design and pilot a HCF audit/monitoring approach (tool to be agreed on with SNV team and related DHOs) that mobilizes DHO/puskesmas to improve WASH conditions in HCF in line with JMP indicators and Gender and Social Inclusion principles and that also includes internationally established protocols for epidemic situations across the 5 indicators

5.    Report and discuss on findings of the pilot, with clear guidance on how to move forward also at the national level (drawing on the cities’ experience)

6. CONSULTANCY LOCATIONS (ALL DONE REMOTELY DURING COVID OUTBREAK)
·       The consultancy will include assessments and consultation meetings at the national level (Jakarta)

·       The consultancy will include assessments and consultation meetings in Bandar Lampung and Metro (Lampung province) and Tasikmalaya (West Java province)

·       Data analysis and report writing can be done remotely though regular meetings are expected with SNV’s team in Jakarta (Kemang)

7. CONSULTANT’S TEAM REQUIREMENTS
It is expected that the team of consultants is constituted by a research expert and by a monitoring/local governance expert. Given the recent introduction of the JMP indicators for health care facilities (established only in 2019, through the latest RIFASKES survey), experience with this issue is valued but not mandatory.

The following requirements are expected from the team of consultants:

Researcher (estimated LoE: 25 days)

1)    Masters level (minimum) in the field of water, sanitation and hygiene (environmental health, environmental engineering, public health or relevant related domains)

2)    Proven track record (at least 3 years) in comprehensive research methods, both quantitative and qualitative, including guiding structured interviews, assessments and consultation processes with different types of stakeholders

3)    Ability to write comprehensive reports with brevity and clarity, distinguishing essential from secondary information and in a language accessible to non academic audiences

4)    Previous experience in consulting/collecting information from local government counterparts

5)    Fluent in Bahasa Indonesia and strong command of written/spoken English

Monitoring/local governance expert (estimated LoE: 45 days)

1)    Master level (minimum) in the field of governance/public administration (regional/local planning, local governance/financing, local development and administration or relevant related domains)

2)    Proven track record in the WASH sector (at least 7 years), preferably including the WASH in health care facilities topic

3)    Demonstrated ability to design monitoring/audit tools/frameworks tailored to existing institutional and regulatory arrangements and to institutionally embed them sustainably

4)    Demonstrated ability to advocate and mobilize local government counterparts for innovative WASH related initiatives

5)    Proven knowledge of national government dynamics and decentralized government arrangements in the Indonesian context

6)    Fluent in Bahasa Indonesia and good command of spoken/written English

8. DELIVERABLES
The research period is approximately 17 weeks and may be started from the 30th April 2020 (or as soon as possible upon consultant appointment and contract assignment).

9. RESPONSIBILITIES
SNV

·       Advise on the assessment set up and design, provide feedback as required;

·       Pay the fee and costs related to the research;

·       Assist with arranging contact with relevant stakeholders (interview, meetings, etc.) as required.

Consultants Team

·       Lead the assessment and produce the deliverables;

·       Involve SNV and relevant local government in the process.

·       Conduct the works with outmost responsibility and respect for local contexts, including the do no harm principle

·       Comply with SNV’s Code of Conduct

10. IMPLEMENTATION ARRANGEMENT
Consultants will report to SNV’s WASH SDGs team leader and will work closely with SNV advisors assigned to support the consultancy in each targeted city.

12. APPLICATION PROCESS
Please send the application documents as follow:

·       Preliminary technical and financial proposal

·       CV of the team members

·       Research references


to indonesia-procurement@snv.org  by 30th April 2020 with the subject “WASH in Health Care Facilities”.


For more information on SNV please refer to our website: www.snv.org


[1] Lawn JE, Blencowe H, Oza S, You D, Lee AC, et al. (2014) Every Newborn: progress, priorities, and potential beyond survival, pp. 4.

[2] Riskesdas, National Health Survey, Ministry of Health, Government of Indonesia (2007), pp. 279, Table 3.210

[3] Blencowe H, Cousens S, Mullany LC, Lee AC, Kerber K, et al. (2011) Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect. BMC Public Health 11 Suppl 3: S11

[4] Odagiri et al. (Under review). Water, sanitation and hygiene services in public health care facilities in Indonesia: Adoption of UNICEF/WHO service ladders to national data sets for a Sustainable Development Goal baseline assessment.

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