1. Background

The Royal Government of Cambodia (RGC) has received vaccine and financial support from Gavi through the Ministry of Health (MoH). The National Immunization Program (NIP), under the National Maternal and Child Health Center (NMCHC), manages these efforts with support from provincial health departments (PHDs), operational districts (ODs), and community networks. Despite over 90% national immunization coverage, marginalized groups—such as urban poor populations—continue to face limited access to vaccines.

RHAC, under the GAVI-funded project, aims to improve healthcare outcomes by strengthening OD profiles. These profiles will serve as dynamic reference points for designing context-specific health interventions for urban poor populations living across five ODs in Phnom Penh and one OD in Siem Reap Province. The profiling process will be conducted in consultation with the NIP, and the Municipal and Provincial Health Departments to ensure alignment with national health priorities and the needs of local authorities.

The OD profiles will capture essential data, including socio-demographics, transportation infrastructure, healthcare networks, geographic factors and Conditional Cash Transfer (CCT) status, to support the development of targeted interventions. Annual updates will ensure the profiles remain relevant as community needs evolve. This thorough examination aims to understand the unique characteristics of each OD, enabling the identification of challenges and opportunities for routine immunization. The insights gained from this data analysis inform the design of customized interventions tailored to the distinct socio-demographic dynamics of each OD.

2. Objectives

The objective of OD profiling is to gather, map, and analyze data to gain a comprehensive understanding of the social, demographic, geographic, and service delivery landscapes in the six targeted ODs. This involves examining 17 key indicators, including socio-demographic data (e.g., children aged 9 to 12 months who have not received full immunization, birth registration certificates, children with disabilities, poverty levels, income levels, and education levels). It also includes information on available village services, such as healthcare facilities, schools, transportation options, and social support programs. The profiling aims to:

• Identify socio-demographic characteristics such as education, family status, poverty, disability, and population structures.

• Integrate geographic data to assess the spatial distribution of healthcare facilities, population density, and service reach within each OD.

• Map community and healthcare networks, including Village Health Support Groups (VHSGs) and community-network.

• Examine transportation routes and industries influencing health service access.

• Assess the status of Conditional Cash Transfers (CCT) and their impact on healthcare access, including the contributions of the Community-Based Health Insurance (CBHI), Health Equity Fund (HEF), National Social Security Fund (NSSF), and other relevant social health protection schemes.

• Conduct a situation analysis of existing and potential resources, highlighting challenges and opportunities.

• Engage with the Municipal/Provincial Health Departments to align data collection and analysis with broader health system goals.

• Provide a framework for annual profile updates to reflect changes in community needs and priorities.

3. Scope of work

The consultant will collaborate with RHAC, NIP, and the Municipal/Provincial Health Departments to:

1. Stakeholder engagement:

1. Meet with PHD/MHD officials in charge of the immunization program, OD directors, and health center chiefs to identify needs to be included in the OD profile development

2. Inception planning:

1. Develop the inception report with key social and service delivery data needed to improve the effectiveness of immunization coverage

3. Tool development and training:

1. Develop data collection tools based on the needs of RHAC and in line with the NIP, and municipal/provincial health priorities.

2. Train data collectors, including HC staff, VHSGs, and RHAC staff, to ensure they are well-prepared for data collection activities.

4. Data collection management:

   • Coordinate with the data collection team to facilitate smooth operations during the data gathering process. Conduct consultations with key stakeholders, including local authorities, VHSGs, and community leaders, to ensure the profiles reflect local realities.

5. Data analysis:

   • Collect primary and secondary data on socio-demographics, healthcare access, and community networks.

   • Analyze industries and transportation infrastructure that impact healthcare delivery.

   • Document healthcare and community networks, identifying barriers and opportunities for collaboration.

6. Feedback integration:

   • Incorporate feedback from the RHAC, NIP, and Municipal/Provincial Health Departments during data collection, analysis, and reporting stages.

7. Profile development and updates:

   • Develop comprehensive for 6 OD profiles, with a table to describe specific conditions for each health center (4 health centers in OD Mekong, 5 health centers in OD Chatumok, 10 health centers in OD Posen Chey, 7 health centers in OD Basak, 5 health centers in OD Prekpnov and 29 health centers in OD Siem Reap) to inform RHAC’s program planning and support coordination with local health authorities.

   • Create a framework for annual updates, ensuring data accuracy and relevance over time.

4. Deliverables

1. Inception report:

   • Detailed work plan, methodology, and data collection tools.

   • List of stakeholders and secondary data sources, including Municipal/Provincial Health Departments.

2. Six OD profiles: one in Siem Reap and five in Phnom Penh

   • Socio-demographic data (family status, poverty, disability, etc.).

   • Geographic-mapping in each health center per OD and transportation data.

   • Overview of healthcare and community networks (e.g., VHSGs, communes).

   • Status of CCT and other relevant financial schemes.

   • Analysis of industries and economic factors impacting service delivery.

   • Key barriers to healthcare access and potential solutions.

3. Draft report and presentation:

   • Summary of OD profiles and preliminary recommendations.

   • Feedback incorporated from RHAC, NIP and the Municipal/Provincial Health Departments.

4. Final report and presentation:

   • Complete OD profiles with actionable recommendations for RHAC and local health authorities.

   • Framework for updating profiles annually.

   • Presentation of key findings and recommendations to RHAC, NIP, and the Municipal/Provincial Health Departments.

5. Methodology

The consultant will use quantitative and qualitative approaches to ensure comprehensive data collection and stakeholder engagement:

Survey population

The survey will target key stakeholders, including:

• Zero-dose children and their caregivers in the identified ODs

• Health facility staff (public and private) involved in immunization services

• Community health workers (e.g., VHSGs)

• Local leaders from communes and villages

• Operational District (OD) and Provincial Health Department (PHD) officials

• Other, CCT

Data collection methods

• Review of secondary data from government reports, health facilities, and community organizations.

• Key informant interviews (KIIs) with local authorities, VHSG members, healthcare providers, and community leaders.

• Focus Group Discussions (FGDs) on Conditional Cash Transfer beneficiaries and vulnerable groups and community leaders.

• Consultations with the Municipal/Provincial Health Departments to align findings with health system priorities.

• Site observations to assess transportation networks and healthcare infrastructure.

• Data triangulation to validate findings and ensure reliability.

6. Timeline

The consultancy will be completed over 8 weeks, with the following key milestones:

• Inception report submission: December 6, 2024

• Data collection period: December 9-20, 2024

• Draft report submission: December 23-27, 2024

• Presentation to RHAC and Municipal/Provincial Health Departments: December 30-31, 2024

• Final report submission: January 1-8, 2025

7. Required expertise

The selected consultant/firm should possess:

• Proven experience in public health data collection and profiling.

• Experience in managing quantitative and qualitative research

• Familiarity with the Cambodian health system and collaboration with local health authorities, especially with the national immunization program.

• Expertise in socio-economic profiling and geographic data analysis.

• Ability to lead research activities, including designing methodologies.

• Proven capacity to produce and present high-quality analysis clearly and accessibly.

• Strong skills in stakeholder engagement and consultation.

• Ability to conduct fieldwork in Phnom Penh and Siem Reap.

• Experience in report writing and presentation to diverse stakeholders.

• Ability to deliver within the specified timeframes outlined in this Terms of Reference (ToR)

8. Ethical considerations

• Informed consent will be obtained from all participants.

• Confidentiality of data will be maintained, and personal information protected.

• Cultural sensitivities and local norms will be respected throughout the process.

9. Budget and payment terms

The total budget will cover consultancy fees, data collection, analysis, and reporting. Payments will be made as follows:

• 30% upon submission of the Inception Report

• 40% upon completion of data collection

• 30% upon submission and approval of the Final Report

10. Submission requirements

Interested consultants/firms should submit:

• Cover letter expressing interest in the consultancy.

• CVs of key personnel involved in the project.

• Proposal outlining methodology, timeline, and budget.

• Two samples of relevant evaluation or research reports.

11. Closing date and submission

• Closing date: November 25, by 5:00 PM Cambodia time.

• Submission email: Please send your submission to Dr. Heng Kheng at hkheng@rhac.org.kh (Tel: +855 77 777 467), with a copy to admin@rhac.org.kh

12. Organization information

Reproductive Health Association of Cambodia (RHAC)

• Head Office: #05, St. 600, Sangkat Boeng Kak Ti Pir, Khan Tuol Kouk, Phnom Penh, Cambodia

• Website: www.rhac.org.kh

• Email: info@rhac.org.kh