NATIONAL CONSULTANT – REDES STUDY

1. Context

Cameroon faces a mixed – generalized and concentrated – HIV epidemic. In the general population of adults aged 15-49, the prevalence is 3.4% [CAMPHIA 2017]. Within key population groups, the prevalence is higher: 24.3% among female sex workers and 20.6% among men who have sex with men [IBBS 2016]. In 2021, the number of people living with HIV was estimated at 499,330, of which 332,354 were women [Spectrum 2021]. The epidemic is female and urban, and youth and adolescents are more vulnerable. Cameroon is on track to achieve the ambitious 95-95-95 targets. With the implementation of the “Test and Treat” strategy, task delegation and decentralization, and community empowerment to provide differentiated services, the country has reached 95-75-82 of the 95-95-95 by 2021.

The response to the epidemic is based on a three-pronged approach: (i) a strong, consistent, and assertive political commitment; (ii) a single, broad-based framework for action that addresses priority targets; and (iii) consistent and permanent funding, even if it has historically been insufficient. Financing the response, especially through domestic funds, remains the major challenge in Cameroon. Addressing this challenge would allow the country to achieve financial sustainability for the HIV response in the long term. This is why it is so important to monitor HIV/AIDS-related expenditures.

With funding from the U.S. Agency for International Development (USAID), Jhpiego leads the 5-year Reaching Impact, Saturation, and Epidemic Control (RISE) global project, which works with countries to achieve a shared vision of attaining and maintaining epidemic control, with stronger local partners capable of managing and achieving results through sustainable, self-reliant, and resilient health systems by 2024. In Cameroon, RISE is providing targeted technical assistance (TA) to support the Ministry of Public Health (MoH) and the Global Fund principal recipients, implementing partners and subgrantees to implement a coordinated comprehensive response in the country. A key activity is the analysis of the flow of HIV/AIDS-related financial resources and expenditures, throug the biannual Ressources et Dépenses de la lutte contre le Sida (REDES), which contributes to the development of strategic information to guide the response.

Cameroon’s Resources and Expenditures for AIDS (REDES) 2020-2021 will take place at a crucial time in the HIV response marked by: (i) the final review of the 2020-2023 National Strategic Plan (NSP) in 2023; (ii) the development of a concept note to mobilize resources from the Global Fund; and (iii) review of the financial sustainability plan for the HIV response.

The 2020-2021 REDES will enable the MOH and partners assess the resources actually mobilized and spent during the first two years of implementation of the NSP, to compare them with the needs and to analyze the financial gaps. It wil also facilitate an analysis of the sufficiency of expenditures by area against the priorities initially set. The 2020-2021 REDES will also serve as a basis for planning and for analyzing the allocative efficiency of the resources to be requested from the Global Fund. Additionally, the 2020-2021 HIV/AIDS expenditures will be analyzed against those of previous years to assess the capacity of domestic resource mobilization and to serve as baseline data for a future financial sustainability plan.

2. Objective and Responsibilities of the Consultant

1. Objective:

The overall objective is to conduct an assessment of HIV and AIDS spending that describes the flow of funds from the origin of resources, the provision of services, and the end use of services provided for the years 2020 and 2021.

The expected outcomes are:

• The capacity of financial managers of key entities involved in the HIV/AIDS response is strengthened on the revised REDES framework and the mechanism for collecting and classifying HIV-related expenditures
• Financial data is collected from all identified structures at both the central and regional levels
• The data is processed and analyzed
• The detailed report is produced taking into account the 2020 and 2021 data
• The report is validated, disseminated

3. Methodology

The approaches and recommendation of the Joint United Nations Program on HIV/AIDS (UNAIDS) will be applied, with primary collection of expenditure data from providers/service suppliers and funding sources. Costing methods, for example, for treatment at hospital for opportunistic infections, will be applied to fill in the missing expenditures. The most logical estimation approach will be applied, based on available data.

The process will take place in three phases:

• Phase 1: Planning, mapping of structures and capacity building of concerned parties
• Phase 2: Data collection and quality control
• Phase 3: Data analysis, validation and report editing

Preliminary work:

As a prelude to the activity, the consultant will support the development of a list of institutions to be surveyed and the distribution of letters requesting their participation, in close collaboration with a task force established to monitor this the analysis.

4. Key deliverables expected:

The consultant shall provide the following results:

• Mapping (database) of key actors in the HIV response, with contact persons and details.
• Data collection plan – teams, schedules, appointment logging, etc.
• Final data collection forms
• Data cleaning and registering into the data consolidation tool
• Validation meeting report with key changes identified/required
• REDES Report
• Development of an outline
• Development of drafts of the REDES report, incorporating reviewers’ comments
• Final REDES report – in accordance with the suggested report outline, with sufficient detail on methods, estimates, data quality and limitations, results (answering all research questions), narrative / analysis / interpretation
• Recommendations for further evaluation and next steps toward institutionalization, appendices (including all respondents and those who did not respond)
• All REDES matrices (or minimum baseline, as per report outline)
• REDES data consolidation tool completed and cleaned up for 2020 and 2021
• Electronic copies of all files used in the collection and processing of data
• The final RTT3 project file, completed, cleaned and corrected, as well as the Excel data consolidation file at each transaction.

5. Profile and qualifications of the consultant

University degree in economics, statistics, health economics, or social sciences with strong research experience in data collection and analysis, preferably in the field of HIV/AIDS, and with experience in conducting EF-REDES surveys.

Required Skills and Experience:

• Good knowledge of HIV/AIDS policy and service delivery and programs in the countries
• Experience with REDES or the Global Health Expenditure Database (GHED) approach
• Strong background in research methods and experience in designing, conducting, managing and analyzing research and data collection processes
• Experience managing a team of data collectors for research products on a national scale
• Good management, analytical, reporting and presentation skills
• Excellent Excel skills