UNICEF recruits 01 International Consultancy for Expanding existing Electronic Medical record platform

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Background and Purpose

Through partnership with UNICEF, MCH program outlined key highlights and recommendations for improving the service delivery by expanding existing Medical record platform to a comprehensive, holistic and integrated system that encompasses the entire MNCH and nutrition programs. Further, the review recommended leveraging this platform towards achieving results along the continuum of care using a cascade approach from hospital, health center and community levels. The EMR is currently implemented in 340 health facilities, and is limited to only a few modules including the HIV package, eHealth Management System eHMS (also referred to as the primary care package) now implemented in 37 hospitals for billing and registration and Bushenge is the only hospital implementing additional modules in EMR including registration, lab, clinical notes, pharmacy and billing. By implementing EMR with comprehensive MNCH/ FP-ASRH and Nutrition  modules, the government of Rwanda would like to address problems related to continuity and quality of care at health facilities and community.

The Government of Rwanda took a decision to adopt the Open Medical Record (EMR) system as a national system to support health care services within hospital and health centers across the country. EMR was created in 2004 as an open source medical record system platform for developing countries. OpenMRS is a software platform and a reference application, which enables design of customized medical records. The system is based on a conceptual database structure, which is not dependent on the actual types of medical information required to be collected, or on particular data collection forms and so can be customized for different uses. This system is based on the principle that information should be stored in a way that makes it easy to analyse and summarize and i.e., minimal use of free text and maximum use of coded information.

This far, some hospitals and health centres in Rwanda and elsewhere have already started using the EMR, however, the benefits so far are immeasurable. Great interest has shown in the health sector to embrace technologies as such and its capabilities to strengthen MNCH, FP, ASRH and nutrition service delivery across the continuum of care and supporting innovative interventions towards achieving the results. Additionally, Rwanda Ministry of Health is committed to achieving the Sustainable Development Goals (SDGs) 2030. The maternal and child health program Plan 2030 and key policy and program documents reaffirm the commitment to the SDGs. The Maternal and child Health program is spearheading several policy and program strategies towards achieving the health targets for the national and global overarching goals.

Justification

Although currently, various data elements are entered into existing EMR separately and exist in virtual silos, clinicians are required to fill out different and mutually exclusive forms, exacerbating strains on a system facing a scarcity of health professionals. Quality of clinical care depends on the knowledge and practice of the health care provider and there is a high degree of variance among providers.

An integrated electronic patient management registry system (EMR) at point of care will be able to guide providers to ensure a minimum standard of quality. Moreover, data for cohort analysis is not available at real time to inform MNCH/ FP-ASRH and nutrition programmes monitoring, management, planning and policy decisions. The system-level improvement is expected to resolve many of these issues, but much more work is necessary to successfully upgrade the existing EMR version, including a possibility to enable the new MNCH/ FP-ASRH and nutrition modules/forms functioning and enhanced to interoperate with existing EMR modules, existing and new eHealth platforms.

The EMR will Strengthen MNCH/ FP-ASRH and nutrition service delivery platforms and ensure equity in coverage and quality which are critical components integral to achieving maternal, newborn, child and adolescent health targets. 

Objectives 

The main objectives of this consultancy are;

• Review and update the new MNCH/ FP-ASRH and nutrition system development road map, and functional requirements,
• Develop MNCH/ FP-ASRH and nutrition electronic modules/Forms and make them available to interface with other existing EMR Modules and existing eHealth platforms like HMIS (DHIS2), components of OpenHIE, CRVS software, and others
•  Enhance the new MNCH/ FP-ASRH and nutrition EMR system with interoperability solutions to communicate through SMS platforms with enrolled mothers, newborns and children within their catchment villages
• Support MCH Program and Quality Assurance departments to assess and document best approach to develop, test and implement the various software modules in Rwanda EMR.
• Assist to enhance functionality, test and pilot new developed MNCH/ FP-ASRH and nutrition software modules in the best and most efficient way in few health facilities
• Capacity Building and Knowledge Transfer share material knowledge for an effective knowledge transfer by working closely with RBC team of developers and implementers while developing, testing, installation and piloting the new expanded MNCH/ FP-ASRH and nutrition EMR system in health facilities.

The project owner, RBC holds full ownership rights of the work undertaken on the project as well as the right to distribute the work among the stakeholders. Knowledge sharing and dissemination is very important to ensure sustainability and functionality of the EMR system at the end of contract.

Key responsibilities / tasks

The Consultant (Senior Analyst and Developer) will support the upgrading/expanding of existing application and data, development, integration, deployment and training phases of this project. This approach must be in line with internationally accepted best practices. During the execution phase of this project, the Senior Analyst and Developer will participate in the validation of the correctness of the software specifications and source-code. The Senior Analyst and Developer will advise and assist a team of RBC software developers in two phases as explained below; 

Deliverable 1: A comprehensive requirement specification report is submitted that includes the updated integrated EMR System development road map with clear functional requirements documented. The report will also comprise description on how other existing EMR modules (HIV, primary care, etc) will be integrated with the MNCH/FP-ASRH modules, interoperability with existing and new eHealth platforms(including OpenHIE), and highlight the architectural differences between version 1.6, 1.9 and 2.4 of OpenMRS in terms of the data model, API, procedures and user Interfaces and development options for the upgrade. This will include the review and update of documents on MNCH/ FP-ASRH and nutrition business analysis and MNCH/ FP-ASRH and nutrition requirement specifications, user centred design, program design and reporting and analytics. 

Deliverable 2: A new EMR system integrating all exiting modules including HIV, primary care instances, the new MNCH/ FP-ASRH and nutrition modules and able to interoperate  with existing and new eHealth platforms (e.g. SMS platform, HMIS/DHIS-2, CRVS platform, and components of OpenHIE) is designed and developed, approved by MoH and handed over to Government and a draft detailed technical documentation describing the architecture for MNCH/ FP-ASRH and nutrition modules/forms is prepared and presented to MoH/RBC, UNICEF and government for comments. 

Deliverable 3: A fully tested and upgraded integrated EMR that is ready to be implemented in a limited number of facilities is presented to RBC/MoH, UNICEF and other key partners/stakeholders for final review, inputs and validation. 

Deliverable 4: i) A final fully functional and enhanced integrated version of the EMR (after fixing issues identified in the implementation at limited number of facilities) as per the specifications from the analysis team that is ready to be scaled up to the rest of the country is handed over to MoH/RBC; and

ii) A final technical documentation that can enable further development, usage, maintenance and growth of the system is handed over to MoH/RBC.

• All deliverables need to be developed in consultation with and approved by RBC/MOH and UNICEF.  

Potential types of reports and technical documents to be prepared and submitted to UNICEF, as part of the deliverables are:

• Report on system development road map with clear and comprehensive functional requirements specifications
• A report with new EMR system integrating all exiting modules and draft detailed technical documentation
• A report on fully tested and upgraded EMR
• A report with final fully functional and enhanced version of the EMR, and a final technical documentation
• Progress Reports and Minutes of Meetings
• Mission Reports
• Technical Reports
• Draft and Final Report
• Training material
• Presentations
• Workshop/training evaluation reports 

Desired competencies, technical background and experience

• The Software Developer must have at least a master’s degree in Computer Science/Information Technology OR a bachelor’s degree with more than eight years of relevant experience.
• 5 years or more of relevant experience in software development
• Strong Java, HTML forms skills
• Solid SQL knowledge
• Object Oriented Programming experience preferred
• Knowledge/experience in developing EMR, openMRS and other forms of patient management systems will be desirable
• Skills in user centered design, program design and monitoring for results and evaluation, health systems analysis and health systems strengthening in general, business analysis, health information exchange and health enterprise architecture are the key skills requirements, and technical/computer programming skills may be an added advantage for this assignment.
• Fluency in written and spoken English is required.
• Knowledge of French and Kinyarwanda will be an asset 

Evaluation Criteria

The average weight (technical and financial) will be used to determine the most suitable candidate.

1. Technical Proposal : 75%
2. Financial Proposal :25%

Administrative issues.

• Interviews if necessary indicating for which experts/position (in general, the evaluation of experts shall be conducted based on submitted CVs)
• Whenever possible, applicant should be requested to provide an all-inclusive cost in the financial proposal. Applicant should be reminded to factor in all cost implications for the required service / assignment
• When travel is expected as part of the assignment, it shall be clearly specified (e.g. location, duration, number of journeys …etc.) in the TOR.
• Applicant shall be required to include the estimate cost of travel in the financial proposal. It is essential to clarify in the TOR that i) travel cost shall be calculated based on economy class travel, regardless of the length of travel and ii) costs for accommodation, meals and incidentals shall not exceed 75% of the applicable daily subsistence allowance (DSA) rates, as promulgated by the International Civil Service Commission (ICSC)
• Unexpected travels shall also be treated as above
• Resources and facilities to be provided by UNICEF; e.g. access to printer, office space, etc.

Project management.

• The consultant will be responsible for all logistical arrangements associated with this contract. UNICEF / MOH will provide a letter of support to facilitate obtaining visa and for support field visits where needed (for quality assurance). Other expenses such as international and local travels, visas, banking/cash services, or office space and equipment (including computers and photocopiers) shall be under the responsibility of the consultant.
• For all contractual issues, the consultant shall report to UNICEF. For technical issues, the consultant shall work directly with technical team led by RBC/or MOH. All deliverables shall be approved by MOH and UNICEF to be considered final.
• The consultant will use his/her own equipment, including computers. UNICEF premises will be available for the meetings and collecting inputs from other partners.
• The consultant shall not make use of any unpublished or confidential information, made known while performing duties under the terms of this agreement, without written authorization from MOH/UNICEF. The products of this assignment will not be a property of the consultant and cannot be shared without the permission of MOH/UNICEF.
• The consultant shall respect the habits and customs of the local population and abstain from interfering in the country’s political affairs. Law no 31/2007 on intellectual property right will be applicable where necessary.
• The consultant shall abide by and be governed by UNICEF Procedure on Ethical Standards in its duties
• All materials developed by the consultant will remain the copyright of MoH/UNICEF, who will be free to adapt and modify the materials for future use. 

Reporting and payment.

• UNICEF will issue the contract and pay the consultant based on the below payment schedule and after the approval of the deliverables by MOH and UNICEF. UNICEF’s Chief of Child health/Health Specialist – in collaboration with MOH – will manage the contract and be the focal point for all contractual matters.
• Payment will only be made for work satisfactorily completed and accepted by UNICEF. UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/deliverables is incomplete, not delivered or for failure to meet deadlines

Please note that the final remuneration will be negotiated by HR. 

Payment Schedule 

Deliverable	Payment proportion
Deliverable 1	10%
Deliverable 2	20%
Deliverable 3	35%
Deliverable 4	35%

 Payment is linked to agreed deliverables upon satisfactory completion and certification of deliverables by the supervisor.

General Conditions: Procedures & Logistics 

Consultants will be required to have expertize in analysis, developing and managing health information systems with specific knowhow of Electronic Medical Records (EMR). In some circumstances, particular logistic arrangements shall be required to ensure time delivery of assigned tasks in quality deserved.

Therefore, in presenting proposals, applicants should take these elements into serious consideration that UNICEF will not be responsible for any unexpected additional cost or arrangement required during the implementation of the assignment.

UNICEF will hire one consultant for this assignment, and the contracted consultant shall be responsible for hiring and paying own sub-contractors (developers or designers) as will be necessary. 

Under the consultancy agreements, a month is defined as 21 working days, and fees are prorated accordingly. The consultant is not paid for weekends or public holidays. The consultant is not entitled to payment of overtime. All remunerations must be within the contract agreement.

No contract activities may commence unless the contract is signed by both UNICEF and the consultant.

How to Apply

UNICEF is committed to gender equality in its mandate and its staff. Well qualified candidates, particularly females are strongly encouraged to apply.

Interested candidates should send their complete Personal History (P11) form, which can be downloaded form (http://www.unicef.org/about/employ/files/P11.doc). or a CV/resume, as well as a cover letter explaining what makes them suitable for this consultancy.

Qualified and experienced candidates are requested to submit a letter of interest including a Technical Proposal outlining a road map for review and implementation timeline. In their letter of interest, candidates should highlight their previous work experience relevant to the assignment, the attributes that make them suitable, their proposed approach to the assignment. Successful applicants will be contacted to provide their financial proposals by email.

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

UNICEF has a zero-tolerance policy on sexual exploitation and abuse, and on any kind of harassment, including sexual harassment, and discrimination. All selected candidates will, therefore, undergo rigorous reference and background checks.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.