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Terms of Reference
HEALTH SYSTEM MODERNIZATION PROJECT
Consultant Terms of Reference
One of the components of the Albanian Health System Modernization Program is to make a thorough assessment of health technologies at public health care providers and an in-depth analysis of supportive systems and standards at the same in order to increase the effectiveness and efficiency of the Albanian health care system and improve health outcomes.
Health technology assessment (HTA) plays an essential role in modern health care by supporting evidence based decision making in health care policy and practice. There is a vibrant and growing community around the world of those who develop and use HTA.
For many people, the term "technology" connotes "hardware" or other mechanical devices or instrumentation; to others, it is a short form of "information technology" such as computer software. However, the practical application of knowledge in health care is quite broad. Broad categories of health technology include the following.
e.g., aspirin, beta-blockers, antibiotics, HMG-CoA reductase inhibitors
vaccines, blood products, cellular and gene therapies
Devices, equipment and supplies:
e.g., cardiac pacemakers, CT scanners, surgical
Medical and surgical procedures:
e.g., psychotherapy, nutrition counseling, coronary
e.g., electronic patient record systems, telemedicine systems, drug
formularies, blood banks, clinical laboratories
Organizational and managerial systems:
e.g., prospective payment using diagnosis-
related groups, alternative health care delivery configurations, clinical pathways, total quality management programs
The Consultancy aims at supporting the development of Health Technology Assessment
capabilities within Albania Health Sector. This component of the overall health modernization
program includes the evaluation and analysis of the situation of medical equipment, drugs,
medical procedures, supporting systems and organizational and managerial systems
2. Proposed Task and Objectives
The Project has four interrelated components:
Component 1: Evaluation of actual situation of divers health technologies in Albania:
devices, medical equipment, drugs, medical procedures, supporting systems ( power
supply system , medical gazes supply system vacuum and compressed air supply) and
organizational and managerial systems
Through this component the Consultant will undertake a needs assessment of medical equipment: elaboration, application and processing of equipment survey, evaluation of actual situation of health technology in the public sector. It comprises the evaluation and analysis of the situation of medical equipment, and the advising on how to establish HTA capacity. Within this component the Consultant will carry out:
An evaluation and analysis of the situation of Medical equipment, advising on how to establish HTA capacity;
An Evaluation of the quality of drugs, medical procedures, supporting systems ( power
supply system , medical gazes supply system vacuum and compressed air supply) and organizational and managerial systems
Component 2: Evaluation and analyses of existing HTA capacities, training and capacity
building of Policy makers and clinicians for institutionalization and use of HTA and
Evidence Based medicine ( EBM) for planning and decision making processes
Within this component, the consultant will carry out:
An evaluation and analysis of the existing HTA capacities
Component 3: Elaboration of a strategy for institutionalization of HTA and EBM in
Albania Provision of HTA software to enable the establishment of HTA infrastructure
Within this Component, the Consultant will undertake: Preparation of the standards for medical equipment and for supporting hospital systems. Provision of HTA software to enable the establishment of health technology assessment infrastructure
Component 4: Evidence Based Medicine training
Within this Component, the Consultant will:
Assess current EBM training at all levels in Albania; Develop and deliver country-wide training on EBM.
Special focus will be on sustainability of the activities through education and broad professional public participation in all activities envisaged.
The specific activities to be undertaken by the Consultant under the Assignment under each phase are:
Component 1: Evaluation of actual situation of divers Health technologies in
Albania: Devices, medical equipment, drugs, medical procedures, supporting systems
(power supply system , medical gazes supply system vacuum and compressed air
supply) and organizational and managerial systems
In particular, the Consultant will undertake the:
Cataloguing & Assessment of Quality of All Medical Equipment at Tirana University Hospital Center “Mother Teresa”, Polyclinic No 1 and Faculty of Medicine in Tirana. Assessment of Optimal Volumes and Quality of Medical Equipment at Public Health Service Providers Assessment of qualities of drugs, medical procedures, supporting systems and organizational and managerial systems
Component 2: Evaluation and analyses of existing HTA capacities, training and
capacity building of Policy makers and clinicians for institutionalization and use of
HTA and Evidence Based medicine ( EBM) for planning and decision
making processes .
Review the existing HTA capacities, training and capacity building of Policy makers and clinicians. for institutionalization and use of HTA and Evidence Based medicine ( EBM) for planning and decision
Component 3: Elaboration of a strategy for institutionalization of HTA and EBM in
Albania Provision of HTA software to enable the establishment of HTA
The Consultant will:
Conduct a systematic evaluation of properties, effects and other impacts of health technologies at TUHC (Tirana University Hospital Centre); Prepare draft standards for health technology and health care delivery regarding the manufacture, use, quality of care, and other aspects of health care technologies; Provide HTA software to enable the establishment of health technology assessment infrastructure. Software must be provided, installed, trained and used at the TUHC. Complete data (catalogues of medical equipment, quality grading etc) must be entered for TUHC. The responsible staff must be trained on application of the software and automatically generated inventories and reports. Conduct presentations and round table discussions at six locations around the country to obtain feedback on draft standards Present final draft of Health Technology standards for Albanian public hospitals
(d) Component 4: Evidence Based Medicine Training
. The Consultant will provide:
Assessment of current training in EBM at three levels (Undergraduate, Postgraduate, CME) Elaboration of introductory training component for EBM (4 day training) Conduct 6 x 4 day trainings throughout the country. There are 12 counties in Albania. The consultant must provide 1 training per 2 counties. The training venue should be selected as conveniently as possible for the trainees. The minimum cumulative number of trainees is 120, that is, an average of 20 trainees per training event.
3. Expected Outcomes
: The Consultant should submit an Inception Report within 1 month
after the start of the consultancy, indicating his work process and dates of planned activities/deliverables
Regular Progress Reports
(bi-monthly). The Consultant shall submit all progress
reports, including executive summaries, in English within 10 days after each two months.
(c) Report containing the assessment of qualities of medical equipments drugs, medical
procedures, supporting systems and organizational and managerial systems
Report on Assessment of existing HTA capacities in Albania
(end of month 5)
Health Technology Standards for Albanian public hospitals
(end of month 7)
HTA software provided and operationalized
(end of month 8)
EBM Training completed
(end of month 9)
(end of month 12)
4. Consultant(s) Profile
The assignment should be undertaken by a consultancy firm that is able to provide all the aforementioned activities. The consultant should have a track record in similar assignments in health systems facing similar challenges. The Consultant should have senior international experience in similar assignments, preferably in the central and Eastern European countries. The firm should have high level managerial experience
The following is a suggested team composition, and may be varied depending on the particular professional background of the Consultant team:
Team Leader: He/she should be professional and practitioner in the field of medical
sciences with at least 10 years international experience in health care technology assessment;
Specialist in Medical Equipment for Public Hospitals: He/she should possess at least 5
years of experience in the drawing up inventories and undertaking assessments of equipment at health care providers. An advanced degree in a related field is highly
desirable, and significant experience in the undertaking such assignments nationally and in CEEC countries is also highly desirable;
Specialist in Support Systems at Public Hospitals: The specialist should possess at
least 5 years experience in the assessment of support systems for hospitals . Significant experience in undertaking such assignments nationally and in CEEC countries is highly desirable. A degree in a related field is required.
Training specialist: At least 5 years of experience in designing and implementing
EBM training programs in other countries. Demonstrated expertise in pedagogical design and teaching is highly desirable.
Other international short term expert: as required in accordance with the organization and methodology of the Consultant to fulfill all requirements of the contract
This consultancy will be carried out between January 5, 2009 to December 20, 2009 (in 12 months time frame).
6. Estimated Level of Effort Required
It is estimated that level of consultant efforts required for this assignment shall be approximately 17 men/months
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