Consultancy – Development of a Toolkit for Business Continuity Planning for Health Centers of RCRC Societies

1. GENERAL

Project(s)

RIPOSTE Project (FRC) / CP3 programme (IFRC)

Mission Objective

Development of a Toolkit for Business Continuity Planning for Health Centers of RCRC National Societies

Zone

Development of toolkit centrally with pilot tests in Cameroon and DRC

Mission reference

French Red Cross:

Osama Afaneh: Public Health and Epidemics Technical Advisor

Valentina Evangelisti: Disaster Risk Reduction Technical Advisor

IFRC_CP3:

Maya Schaerer: Grant Manager, Epidemic Pandemic Preparedness

Wbeimar Sanchez: Senior Officer, Epidemic Preparedness and Readiness

GDPC:

Omar Abou-Samra: Director, GDPC

Gerda Wilcox: Advisor

Desired start date

1st of february 2023

Desired end date

30th of June 2023

Mission duration

Maximum of 70 Days

1. FRAMEWORK AND RATIONALE

In the past years the international community has been faced with widespread events including outbreaks of epidemics and disasters. To limit the impact on human suffering during those events the need for effective responses at a global and more importantly at a local level has been demonstrated. The recent COVID 19 pandemic showed the need for local communities to be able to respond to epidemics; including prevention, surveillance, treatment and short/long term recovery. There has been a focus on improving the effectiveness of clinical case management, but a gap still exists in the areas of prevention, local capacity management, coordination of efforts and efficient and adaptive responses to epidemics and disasters.

Preparedness and response to epidemics and disaster risk management are linked as evidenced by the impact that disaster events have on populations health and wellbeing Yet, frequently disaster risk management and epidemic preparedness and response programs are developed in silos and are not coordinated, resulting in outcomes that are less than optimal for the impacted populations.

During epidemics or disasters, the health system is faced with a significant increase in demands for services. That increase in demand can quickly lead to the health system and in particular health centers, to being overwhelmed and unable to address the healthcare needs of the population. The COVID19 epidemic is a clear example where health systems faced challenges with lack of equipment, bed capacity and human resources to meet the needs of the population. The lack of Personal Protective Equipment posed a significant risk to the staff providing care to COVID19 patients. This pandemic showed the susceptibility of health care systems to respond effectively to a sudden increase in need for services putting additional pressure on the primary health care system to continue to provide routine services for populations in need. The impact on health services delivery was even more pronounced in countries with high populations under the poverty line and limited access to resources.

This highlights the need for business continuity plans, for health facilities and centers owned and managed by Red Cross Red Crescent (RCRC) National Societies (NS), that facilitate reacting to changing needs and mobilizing across multiple fronts to address the healthcare needs of a population, in particular in contexts that are exposed to multiple hazards and risks. Medical responses to outbreaks and disasters follow specific protocols and processes and are adapted to meet various needs. Measures to assure continuity of services during outbreaks and disasters, need additional development to address the specific needs of Health Centers and the communities they serve. This is also coupled with the need to build capacities and health system resilience to prepare for multiple shocks such as the combination of new potential future outbreaks and disasters.

Business Continuity Planning is a planning and preparedness practice aiming at ensuring the continuity of services in adverse conditions, for example during and after a disaster. While it is becoming a practice in some countries in the private sector, it is not yet the case of all RCRC National Societies’ health centers. Epidemics or disasters have the potential to create disruption of services. Implementing a Business Continuity Plan is essential to work toward the continuity of health services in adverse conditions. The RCRC National Societies Business Continuity Planning toolkit developed by the Global Disaster Preparedness Center (GDPC) will be used as a starting point for this activity and adapted to meet the needs of the RCRC health centers.

1. RCRC work linked to the scope of work

French Red Cross: The RIPOSTE Programme

The goal of the RIPOSTE program (funded by the French Development Agency – AFD) is to strengthen the capacities and expertise of the French Red Cross in the face of epidemics and disasters. The program focuses on improving the capacities of various health and disaster risk management actors in the prevention, preparation and response to epidemics. Furthermore, it will also strengthen the capacities of the Red Cross/Red Crescent (RCRC) National Societies, enabling them to strengthen the resilience of vulnerable communities in the face of epidemics, using the program’s resources (training, manuals, guides, revision of contingency plans, etc).

The objectives of the RIPOSTE program are to standardize epidemic preparedness and response approaches; leveraging IFRC’s experience and standardized tools, by using, building on and deploying those tools to be used on the ground through FRC ongoing programmes, and to facilitate the integration of Disaster Risk Reduction (DRR) approaches in Epidemics preparedness and responses.

The International Federation of Red Cross and Red Crescent (IFRC): the Community Epidemic and Pandemic Preparedness programme (CP3)

Since 2017, the IFRC has been running a multi-country epidemic and preparedness programme called CP3 with funding from the U.S. Agency for International Development (USAID). Through CP3, IFRC is supporting communities, National Societies and other partners to prevent, detect and respond to disease threats. In doing so, they can play a significant role in preparing for future epidemic risks. CP3 is currently active in 7 countries: Indonesia, Uganda, Cameroon, Kenya, the Democratic Republic of Congo, Sierra Leone and Guinea. It was also previously active in Mali.

IFRC is also supporting the development and standardization of approaches and tools related to epidemic risk management, learning from programmes and response operations. The IFRC plan and budget 2021-2025 flagship initiative “Global Health Security: Epidemic-Pandemic Preparedness and Response”, provides an opportunity for the IFRC Network to increase its footprint in Global Health Security, scaling up activities at the community-level, while strengthening its institutional capacity to manage epidemic risk and engaging with other key stakeholders.

The Global Disaster Preparedness Center (GDPC):Business Continuity Planning Toolkit

The Global Disaster Preparedness Center (GDPC) is a reference center established by the American Red Cross and the International Federation of Red Cross and Red Crescent Societies (IFRC) to support innovation and learning in disaster preparedness. The GDPC aims to enhance disaster preparedness capacities of RCRC national societies. It has developed multiple resources and tools for Business Continuity Planning for RCRC National Societies. These resources help support RCRC National Societies* maintain community confidence in the RCRC’s emergency response capabilities by providing tools and guidance that allow them to continue operations during crises and minimize the effects of interruptions of service operations.

1. OBJECTIVES, METHODOLOGY, RESULTS, ACTIVITIES

Overall Objective for the mission

Create a comprehensive Business Continuity Planning Toolkit for RCRC Health Centers to ensure the continuity of routine health services in RCRC NS Health Centers, in contexts of epidemic outbreaks and/or disasters. The toolkit will be developed in English first and will include tools/materials and a step by step approach to drafting a health center business continuity plan. The toolkit is to be translated to French before the phase of piloting in the francophone piloting countries.

Specific objectives

• Collect existing evidence and experiences on the approach of Business Continuity Planning of the GDPC.
• Review existing literature on Continuity of Care of Health Structures in times of hazards and particularly during epidemics/pandemics as well as disasters.
• Consultation with RCRC National Societies as well as government officials and key stakeholders of pilot countries in the development of guidelines and strategies
• Develop a toolkit including guidelines, tools and approaches for the health centers to facilitate continuity of services during epidemic outbreaks and/or disasters (content of toolkit is detailed in the deliverable section below)
• Test the toolkit in the predefined zone of intervention in one health center for each country through the CP3 programme
• Contribute to build epidemics and disaster preparedness capacities for Health Centers based on scientific evidence
• Disseminate the Business Continuity Toolkit internally (RCRC) and externally

Methodology

The methodology for creating the Business Continuity plan will be based on adapting existing material, conducting a literature review for recommended approaches and putting the healthcare centers at the center of the development approach. The team will seek and integrate feedback from users and devise a design and testing strategy that allows for a continual feedback loop.

High-level steps are outlined below:

• Identification of key stakeholders including key informants to interview in the process at both global and country levels (this would include representatives from the countries national societies, ministries of health and identified health centers, as well as local actors at the community level.
• Review of existing literature on continuity of care for Health Centers and Primary Care during epidemics and disasters
• Drafting a detailed outline for the development of the new health centers business continuity planning toolkit.
• Review of the RCRC National Societies Business Continuity Planning Toolkit
• Adoption of a participatory approach, including a consultation with RCRC National Societies and potentially government officials from the Ministries of Health in the countries of pilot.
• Modification of the GDPC Business Continuity Planning Toolkit to include findings from the literature review including approaches for epidemics and disasters for a health center to respond to epidemic outbreaks and disasters.
• Development of a comprehensive testing plan for the new toolkit
• Identification of two representative Health Centers, one in each country to test and pilot the adapted Business Continuity Planning Toolkit where the new toolkit will be tested (this includes accompanying the health center to draft their business continuity plan using the toolkit)
• Incorporation of test results and feedback into the toolkit
• Finalization and validation of the Business Continuity Planning Toolkit by stakeholders (IFRC, GDPC and FRC)
• Dissemination of the toolkit through GDPC website and IFRC channels

Approach

The consultancy will follow a phased approach according to the following 3 phases:

Phase 1: Preliminary review phase: (Maximum of 15 days) (Financed by FRC)

1. Inception report: initial research and desk review to identify practices for community health center BCP (5 days)
2. Key Informant interviews: conducting individual interviews with key field stakeholders and consultation sessions with key actors (GDPC, IFRC, FRC, etc.) (5 days)
3. Development outline: Design outline and concept for business continuity approach for Community Health Centers including KPIs, theory of change and other foundational components (5 days)

Phase 2: Toolkit development phase** (Maximum of 25 days) (Financed by FRC)

• Development of a Business Continuity Planning Toolkit for health centers to facilitate a response to epidemics and disasters (15 days). This toolkit will include the following:
  • Business Continuity Planning Guideline
  • Business Continuity Planning Template for events such as epidemics and various natural and man-made disasters
  • Business Continuity Planning Check-List
  • Business Continuity Plan – Risk Assessment Matrix
  • Business Continuity Plan – Risk Mitigation Approach
  • Business Continuity Plan – Critical Incident Staff Matrix
  • Delegation of Tasks and Responsibilities
  • Business Continuity Plan – Recovery Strategy
  • Maintenance and Sustainability Plan
• Feedback round and validation of the toolkit by the IFRC, GDPC and FRC (5 days)
• Translation of the Toolkit to French to prepare for the testing phase. (5 days)

Phase 3: Toolkit pilot testing and feedback phase (Maximum of 30 days) (Financed by IFRC)

• Implement testing plan in two target health centers (testing plan for one Health Center each in each zone)*** (7 days per country)
• Collect feedback from the Health Centers as well as involved stakeholders from the country RC national society (5 days)
• Create a list of recommendations and a report to improve the initial tool developed in Phase 2 (3 days)
• Revise output based on the results and feedback from the testing phase (3 days)
• Adapt and validate the final version of the Business Continuity Planning Toolkit by the IFRC, GDPC and FRC and prepare for dissemination (5 days)

Deliverables

Phase 1: Preliminary review phase

• Inception report including results of literature and desk review
• Key Informant interviews reports
• Development outline document

Phase 2: Toolkit development phase

• The validated Business Continuity Planning Toolkit with the following components (In English and French)
  • Business Continuity Planning Guideline
  • Business Continuity Planning Template for events such as epidemics and various natural and man-made disasters
  • Business Continuity Planning Check-List
  • Business Continuity Plan – Risk Assessment Matrix
  • Business Continuity Plan – Risk Mitigation Approach
  • Business Continuity Plan – Critical Incident Staff Matrix
  • Delegation of Tasks and Responsibilities
  • Business Continuity Plan – Recovery Strategy
  • Maintenance and Sustainability Plan

Phase 3: Toolkit pilot testing and feedback phase

• Activity reports from toolkit pilot tests
• Report on recommendations to improve toolkit based on feedback and pilots
• Final validated Business Continuity Planning Toolkit

5. PROCESSING OF OFFERS

Profile of the consultant(s)

• Public Health background with understanding of epidemics prevention preparedness and response
• Knowledge or previous experience in health care facility management (preferably RCRC facilities)
• Knowledge or previous experience with approaches and concepts to epidemic and disaster preparedness, contingency planning and business continuity planning
• Knowledge of the Red Cross Red Crescent movement
• Experience conducting ateliers and trainings with experience in pedagogical approaches and tools
• Experience in public health/humanitarian/development sector
• Experience in multicultural contexts
• Fluent in both English and French with excellent communication and writing skills

Administrative clauses

• The contractor must provide proof at the time of submission of the regularity of their economic activity (tax documents, registration, registration as a self-employed person – depending on the country of reference where the contractor is established).
• The contractor alone must provide the means necessary for the accomplishment of their service, whether material or human: air tickets, computer, professional liability insurance.
• The contractor may delegate part of the mission, to another person of their choice within their team, but they remain the sole hierarchical and disciplinary authority for their employees. The contractor must ensure the security, and as such insure the consultants sent on missions.
• Two contracts are to be signed for this consultancy: a contract with the FRC for the first two phases of the approach described above, and a separate one with the IFRC for the 3rd phase.

* for more info, visit: https://preparecenter.org/toolkit/business-continuity-planning-help-desk/

** Ideally Toolkit is to be developed in English first and later translated to French before the testing phase (II), keeping in mind that field consultations as well as piloting are to be conducted in francophone contexts, while Enlgish is the communication language for the working group overseeing the work of this consultancy.

*** Prior to field visits, some preparatory work is to be conducted remotely with the health centers to prepare for the atelier of elaboration of the business continuity plan (this could include initial context and risk analysis, risk prioritisation, etc). Delegates on the ground of the FRC as well as the IFRC could support some of the preparatory steps if on the ground support is needed.