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| TERMS OF REFERENCE |
1. Background: The Global Polio Eradication Initiative (GPEI) is a multi-country effort, which will contribute to a global public good, i.e., the global eradication of Poliomyelitis. The Nigeria Polio Eradication Initiative (PEI) as part of the global effort and is being implemented by the Expanded Program on Immunization under the overall guidance of the Federal Ministry of Health. The Country has been supported by the World Bank through the Partnership for Polio Eradication Project (PPEP)to support the elimination of Polio in the World, and in particular, of the elimination of poliomyelitis in Nigeria (the only endemic country in the continent).
2. Partnership for Polio Eradication Project and IDA Buy-down Mechanism: The project was designed by the World Bank to help finance eradication in remaining endemic countries in Africa and Asia in partnerships with the Bill and Melinda Gates Foundationto provide polio endemic countries with IDA financial resources without IDA repayment obligations, “the IDA Buy-down mechanism”. The buy-down mechanism aims to convert a normal IDA development credit to grant terms through provision of external donor resources under clearly defined performance criteria. In the context of the Nigeria: Partnership for Polio Eradication Project, resources for the buy-down have been made available by an agreement between IDA and, the Bill & Melinda Gates Foundation (BMGF).
3. The donor provided funds to an IDA-administered trust fund: the Polio Eradication Trust Fund that will buy-down the debt incurred by recipient countries after successful implementation of the project. In addition, the Trust fund makes commitment and service charge payments to IDA on behalf of the recipient’s countries during project implementation. The buy-down of the principal amount of the credit will occur upon successful completion of the project after determination by an independent performance audit. As agreed during the establishment of the trust fund, once the Project has been fully implemented, an entity selected by the World Bank will conduct a performance audit confirming the adequate quantities of OPV arrived and were appropriately utilized in the Country. The performance audit will determine if the IDA funds achieved their intended results against agreed indicators. If the performance audit evaluates the project as satisfactory, the IDA buy-down will be triggered. The earmarked funds in the trust fund will be used to pay off the IDA credit at the net present value of the credit based on the defined foreign exchange and discount rates to buy-down the principal of this credit (Repayment Amount). IDA will in turn cancel this credit and release the recipient from any future liability. If the independent performance audit evaluates the project as unsatisfactory, the recipient will remain obligated to pay back IDA on the terms of the credit and the trust fund buy-down will not be triggered.
4. The NigeriaProject: Partnership for Polio Eradication Projecthas been supporting PEI from 2003 with the parent projectand subsequently with the first Additional Financing in 2005and second Additional Financing in 2009. The project purpose was to assist the Government of Nigeria (FGoN) to eradicate Poliomyelitis from Nigeria. The project development objective was to support the supply of the additional oral polio vaccine (OPV) for the country’s supplementary immunization activities (SIA), i.e., for conducting National Immunization Days (NIDs)and possibly “mop-up operations”. To achieve desired results, a new and innovative Immunization Plus Days (IPD) Strategy was adopted. In this strategy, multiple antigens are offered to all eligible children. For polio eradication, all children under the age of 5 receive OPV during every campaign and vitamin A twice a year through temporary fixed posts and house-to-house teams. Other vaccine preventable antigens are administered to all children under the age o f 1 at the temporary fixed post. This strategy, which boosts routine immunization through the use of vaccination cards and, where possible, the use of temporary fixed posts in health facilities within thesettlements or wards, will be continued.
The project had only one component, i.e., the procurement and supply (through UNICEF) and use of OPV. The other two components of PEI including logistics, social mobilization, training, surveillance, monitoring and evaluation have been supported by WHO and UNICEF through bilateral donor and private agency contributions.
5. The original project financing was US $ 33 million. Despite efforts during supplemental immunization activities around the country, low intensity transmission of the wild polio virus persisted in some 12 endemics States in the Country requiring intensification of SIAs. This led to additional financing of $50.00 million for procurement of OPV in 2005 and the second additional financing in the amount of US $50.00 in 2009. The Project has completely disbursed its funds and the closing date associated with the second Additional Financing is April 29, 2012. AS the final disbursements have been made the project has initiated steps to carry out the performance audit for measuring the triggers so that decision on the buy-down can be made. As per the Agreement between the Gates Foundation and the IDA, Buy-Down completion date is December 31, 2012.
In order to trigger the buy-down mechanism, The World Bank is seeking a consulting firm to undertake the performance audit of the Project.
6. Objective: The objective of the performance audit is to determine if the IDA funds achieved the intended results against agreed indicatorsunder the Nigeria Partnership for Polio Eradication Project. The performance audit will measures the results for two indicators:
- Timely arrival at national level of OPV procured through UNICEF. Target: vaccines arrive at least 3 weeks before the SIA in the national strategic store in Abuja. Tool: UNICEF/NPHCDA vaccine arrival report.
- Immunization coverage of SIA: Target: at the end of the credit, immunization coverage of OPV is at least 80 percent in each endemic state. Tool: cluster sample survey according to a WHO approved methodology.
7. Responsibilities: The performance audit consultantwill:
- Review available background information on PEI and Nigeria partnership for Polio Eradication Project including Project appraisal documents; Development credit agreements project reports;
- Review appropriate documents to determine the arrival of OPV at the national level 3 weeks before the SIA (to remain in sync with the IDA buy-down project document). To carry this out the audit team will refine measurement tools it will use to evaluate performance. For example, the team may chose to review and triangulate information through fund disbursement dates, Vaccine Arrival Reports, ERC recommended SIAs schedule,SIA records including program and stock registers and utilization reports.
- Furtherif the arrival was delayed: (i) Assess if the delay resulted in a subsequent delay in the implementation of the planned SIA (3 week cut off should be measured against the core objective, which is to have OPV delivered at the end-user level well in time for a smooth implementation as per the plan (ii). Also assess if the delay was due to the late order placement or late release of funds for OPV procurement or other global epidemiological and vaccine logistic issues.
- Based on findings the firm will make comments on achievement of the set targets and ascertain if there were delays in vaccine arrival whether these were within the control of FGoN or factors beyond their control.
- The audit team will design a 30 X 7 cluster survey for the 4 high risk states as outlined in the 19th ERC (Kano, Katsina, Zamfara and Borno) and carry out a survey within 7 days of the anticipatedOctober SIA. Sample selection will be done using probability sampling taking into account the cluster sampling technique and using the standard WHO 30 household cluster survey technique. A total of 30 clusters will be taken from each State and vaccination coverage data on children less than 5 years will be collected from 7 households in each cluster, each house having at least 1 child below 5 years of age. For the purposes of the survey, every Ward in the State will be further grouped into known transmission zones of high, medium and low based on understanding of the poliovirus epidemiology. In each State, the survey will be have an equal number of samples drawn from high, medium and low transmission wards from the list as prepared by the national campaign cell using EPI-Info. Based on the above, comment on coverage rates achieved in each of the 4 high risk states. The information collected will be reviewed against other coverage data available including the independent monitoring data and LQAS if available.
- Develop and agree with FGoN and the Bank team, work plan, methodology, reporting format and timeline for the performance audit report;
- Discuss Draft findings with key counterparts in FGoN, UNICEF, WHO and the Bank.
- Provide a final report within 10 days of receipt of consolidated comments from the Bank.
8. Deliverable: Performance Audit Report clearly determining whether the IDA funds used under the project achieved their intended results against agreed indicators.
9. Qualifications: The consulting firm should include experts with advanced degree in Public Health/ Monitoring and Evaluation/ Bio Statistics/ Logistician with extensive experience in working in international health and development field especially in immunization programs. The team may need to sub-contract with a local survey firm to carry out the survey. The team should have specific expertise in monitoring and evaluation of immunization programs. In addition the team should have excellent writing skills and familiarity with Sub-Saharan Africa region.The team should not include any staff or member from the Global Polio Eradication Initiative to avoid conflict of interest.
11. Schedule:It is anticipated that undertaking the performance audit will require 3-4 weeks of full time work by the consultant. The audit need to coincide with supplementary immunization activity (be performed right after, maximum one week) to facilitate the survey and physical verification (ink marks on vaccinated children). The exact schedule will depend on when the FGoNwill conduct an immunization campaign; approximately in October 2010 and the assignment would need to be completed by the end of 2010.
Immunization Coverage –Cluster Survey Reference Manual WHO 2005
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