Consultant - Development of Disaster-responsive Package of Essential Noncommunicable Interventions (PEN-D) and Prototype minimum Initial Service Package (MISP)

IFRC DRC opened a position of Consultant for the Development of Disaster-responsive Package of Essential Noncommunicable Interventions (PEN-D) and Prototype minimum Initial Service Package (MISP).  Interested candidates should submit their application material (as mentioned in ToR) by Thursday, 17 April 2025 to the following e-mail: aliza.baidya@ifrc.org

Terms of Reference

Title: Development of Disaster-responsive Package of Essential Noncommunicable Interventions (PEN-D) and Prototype Minimum Initial Service Package (MISP) for integration into Local Disaster Preparedness and Response Plans in Kailali and Kanchanpur Districts.

1. Background

Non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, represent a significant global health challenge, contributing to nearly 41 million deaths annually. A staggering 86% of these premature NCD-related deaths occur in low-and middle-income countries (LMICs). In Nepal, NCDs have emerged as the leading cause of premature mortality and morbidity. In 2019, NCDs were responsible for 71.1% of deaths and are projected to contribute to 78.6% of total deaths by 2040.

The economic burden of NCDs in these regions is substantial, with projected costs reaching $21.3 trillion between 2011 and 2030. Managing NCDs is often very challenging in emergency settings. Emergencies can increase the risk of acute NCDs exacerbations and decrease the ability of health systems to respond.  Despite these dire statistics, NCD care remains under-addressed in disaster preparedness and response strategies globally and in Nepal.

The Nepal Red Cross Society (NRCS) has been implementing the project “Resilience NCD: Strengthening NCD Care Resilience in Disaster-Prone Municipalities of Western Nepal” together with the support of the Danish Red Cross (IFRC DRC), Canadian Red Cross (IFRC CRC),  Aarhus University, funded by the Novo Nordisk Foundation. The project is being implemented in Bhajani Municipality and Laljhadi Rural Municipality of Kailali and Kanchanpur districts, respectively. These areas are characterized by their high vulnerability to natural disasters, including floods, landslides, and earthquakes. The selected sites are particularly prone to flooding due to their proximity to major river systems originating from the Chure hill range. The monsoon season, spanning from mid-May to mid-October, significantly heightens the risk of such disasters. The population in these municipalities is predominantly rural, with limited access to healthcare facilities and services. The project's duration spread from 1 April 2024 to 31 March 2026.

The three key components of the project are:

• To design a package of essential NCD interventions for disaster preparedness and response (PEN-D), 
• To integrate the PEN-D with existing and tested early warning, early action (EWEA) and anticipatory action (AA) approaches, and
• To test the feasibility of PEN-D with an EWEA/AA flood simulation and real response.

This is a research-driven project that employs a mixed-method design with qualitative and quantitative methods to generate information about profiles of major NCD burdens in the targeted municipalities, assessing the barriers and facilitators for NCD patients seeking services during disasters, including their inclusion in early warning systems. The project aims to develop a tailored disaster-responsive NCD Care Package (PEN-D) and prototype Minimum Initial Service Package (MISP) that can be integrated into the Humanitarian-Development-Peace Nexus to strengthen community resilience and enhance Government disaster risk management strategies. Through a holistic participatory approach, the project aims to bolster the resilience of Nepal's healthcare system and safeguard the well-being of individuals living with NCDs with access to continuity of care before and during emergencies.

2. Objectives of the Study

To develop evidence-informed, disaster-responsive essential NCD care package for disaster preparedness and response (PEN-D) to ensure individuals living with NCDs have access to continuous care before and during emergencies along with a prototype of the Minimum Initial Service Package (MISP) that can be integrated into the local disaster preparedness and response plans of Kailali and Kanchanpur districts.

Specific objectives

• To apply a Delphi technique to achieve expert consensus on the design and essential components of PEN‑D and MISP, based on project data, evidence and national context.
• To develop a tailored NCD care package (PEN‑D) for use across all disaster phases (preparedness, response, recovery), aligned with existing NCD policies and disaster frameworks.
• To develop a prototype of the Minimum Initial Service Package (MISP) that is ready to integrate with the local disaster preparedness and response plan of Kailai and Kanchapur district.

3. The study sites and potential contributors

The Delphi study will adopt a mixed approach, combining online surveys with in-person consultations and workshops. The process will begin with an initiation workshop held in Kathmandu and in one of the two project districts—Kailali or Kanchanpur (selected based on feasibility and stakeholder availability). A final co-design and consensus-building workshop will be conducted in Kathmandu to validate findings and shape the final PEN-D and MISP outputs.

The Delphi process will engage a diverse group of experts and practitioners working at the intersection NCDs and disaster risk management. Participants will include representatives from key government bodies and technical departments, including the Ministry of Health and Population (MoHP), Health Emergency Operation Centre (HEOC), Epidemiology and Disease Control Division (EDCD), Nepal Health Research Council (NHRC), National Health Training Center (NHTC), National Disaster Risk Reduction and Management Authority (NDRRMA), Department of Hydrology and Meteorology (DHM), Ministry of Federal Affairs and General Administration (MOFAGA), and the Ministry of Home Affairs (MOHA).

In addition to government stakeholders, the process will involve health service providers and clinical experts, disaster response agencies and emergency service units, local administrators and municipal authorities, as well as academic institutions and research organizations. Engagement with relevant NGOs, INGOs, and development partners will also be prioritized and will be finalized in close coordination with the project team, Co-PIs, and PIs.

The consultant or consulting firm is encouraged to suggest additional qualified experts and institutions for inclusion in the Delphi process to ensure a robust, representative, and context-appropriate consensus that strengthens the development of the PEN‑D and MISP deliverables.

4. Scope of the work 

The purpose of this Terms of Reference is to engage a qualified consultant or team of consultants/experts to support the ResilienceNCD project in designing a contextually appropriate, evidence-informed PEN‑D and prototype MISP. This will be achieved through the application of a robust Delphi consensus-building process, grounded in stakeholder engagement and the realities of NCD care in disaster-prone settings in Nepal.

4.1 Apply Delphi techniques for gathering expert opinions.

• Lead the entire Delphi Process, including pre-Delphi workshop, co-design workshop when necessary.
• Develop a detailed Delphi process framework, including scope definition, expert selection criteria (in collaboration with the project team), and tailored tools/instruments such as questionnaires and rating forms based on the scope of TOR, in close coordination with the advisory team.
• Facilitate multiple Delphi rounds (as needed), ensuring inclusive participation, clarity of communication, and methodologically sound iteration toward consensus on PEN‑D and MISP content.
• Analyze /responses thematically/categorically from the experts/practitioners to determine the consensus level and refine accordingly.
• Present key findings and consensus recommendations in a report.

4.2 Development of PEN-D and Prototype of MISP

• Based on the findings obtained through Delphi techniques, develop a tailored NCD care package (PEN-D) considering the pre, during and post-disaster situation reflecting variations in disease severity, service availability, and system readiness.
• Develop a prototype of MISP that integrates NCD care, aligning with existing NCD policies/ frameworks.
• Validate the proposed draft of PEN-D and prototype of MISP with relevant stakeholders through focused workshops/consultations

4.3 Reporting and Dissemination

• Prepare a detailed process report outlining the Delphi methodology, participant engagement, data analysis, and final recommendations.
• Present key findings, validated outputs, and policy implications to stakeholders in a dissemination event organized by the project team.
• Submit all finalized outputs, including the PEN D, MISP prototype, and supporting documentation, to the project team for handover.

4.4 Other considerations for the data collection process

• Ensure that informed consent is obtained from all the participants before before any data collection, interviews, or photography.
• Handle all data in compliance with applicable national regulations and international standards, including the General Data Protection Regulation (GDPR) where applicable.
• Uphold ethical research and engagement practices, particularly around community participation, data confidentiality, and representation of vulnerable groups.

5.  Deliverables and Timelines

6. Qualification and Experience

The consultant or consulting firm should possess:

• Higher degree of either a Master's or a PhD in Public Health, Implementation science Epidemiology, or Health System, or other relevant sector. Having an additional degree in Disaster/Crisis Management would add value.
• Proven experience in conducting Delphi studies or similar consensus–building studies for developing guidelines/service packages etc.
• Involvement/experience in NCD care package development, conducting implementation research, or a similar type of work, or record of accomplishment.
• Records of accomplishment of similar type analytical skills and experience in qualitative and quantitative and health system works related to humanitarian peace nexus.
• Extensive hands-on experience and knowledge in designing qualitative research, qualitative analysis, and data presentation based on the common theme, pattern, and insights that reflect the participant's perspective.
• Excellent facilitation and communication skills, with a strong track record of engaging diverse stakeholders, including government actors, civil society, community representatives, and academic institutions.
• Knowledge and experience on the inclusion of GEDSI (Gender Equality, Disability, and Social Inclusion), Senior Citizens, and marginalized populations in the health system research process with a focus on understanding intersectional vulnerabilities such as the intersection between gender, disability, caste, and ethnicity in accessing healthcare services.
• Have previously developed health sector manuals, service packages, strategies, guidelines, and policy paper for development and emergency contexts.

7. Supervision and Reporting

The consultant or consulting firm will report to the project team/technical team representing NRCS, IFRC CRC, IFRC DRC, and Aarush University. The regular update of the development will be provided through a virtual or physical meeting as per the need.

8. Budget

The consultant is asked to submit a budget proposal for the delivery of the services outlined above, along with a tentative work plan, including the working days for the main activities and milestones. Submit a financial proposal in NPR, including all applicable tax/VAT. Payment will be made as per IFRC standard terms and payment after submission of invoice including supporting documents. In your financial proposal, please mention the terms of payment and state clearly in your proposal if your payment term is different.

If consultant needs to visit the field, the IFRC DRC will cover all travel and accommodation costs as per actual basis & per diem will provide as per IFRC policy. The consultant is required to fill up the Mission Order and send it to the IFRC/IFRC DRC for approval process before starting the field visit.

In your financial proposal, please mention the bank details:

Bank Name:

Account Name:

Account Number:

Branch

9. Responsibilities of NRCS and Consortia partners

NRCS/IFRC DRC shall provide necessary support in organizing the Delphi workshops, including logistic support. In addition, the society will support in identification of potential experts/practitioners and in development of an outline of the PEN-D Package content. Furthermore, the NRCS and Consortium partners will also provide related reference documents to consultants, inputs during consultative meetings/interviews, monitoring the study process and study tools/draft reports. However, NRCS encourage the consulting firm to exhibit pro-activeness in coordinating with concerned stakeholders, organizations and prospective respondents.

10. Contract duration

The duration of the entire process will span from April to June 2025 for 40 working days.

11. Quality and ethical standards

The consultant/consulting firm will sign and adhere to the NRCS code of conduct, Key institutional policies and standards, the Community Engagement and Accountability (CEA), Protection, Gender and Inclusion (PGI), Child Protection, etc. All materials produced by the service provider must align with the ethical values and principles of the Red Cross and Red Crescent Movement and be validated and approved as needed. The seven Fundamental Principles of the Red Cross and Red Crescent: 1) humanity, 2) impartiality, 3) neutrality, 4) independence, 5) voluntary service, 6) unity, and 7) universality. Further information about these Principles can be obtained at: www.ifrc.org/what/values/principles/index.asp

12. How to Apply

Interested individuals and organizations should submit the following documents to Ms. Aliza Baidya at aliza.baidya@ifrc.org by 17th April 2025. Please be informed that the technical and financial proposal must be submitted as a separate document. The incomplete proposal in all respects and proposals submitted after the deadline will not be considered.

Required Documents:

The interested Consultants or consulting firms should submit:

• A detailed CV with highlights on relevant points mentioned in qualifications and experience of the ToR
• A technical proposal outlining their approach, methodology for implementing the Delphi study
• A financial proposal detailing consultancy fees and any other associated costs.

In case of a Consulting firm,

• Should submit all the relevant documents of its existence (e.g. Registration, PAN, VAT, etc.)
• Detailed CV of expert/s with highlights on relevant points mentioned in qualifications and experience
• A technical proposal outlining their approach, methodology for implementing the Delphi technique
• A financial proposal detailing consultancy fees and any other associated costs.

We thank you in advance for understanding that only short-listed candidates, individuals, or organizations will be contacted for the next step in the application process.