CALL FOR CONSULTANCY SERVICE

Conducting the assessment of the out-of-pocket expenditure and willingness to pay for PLHIV accessing SHI ART
and viral load services in Vietnam

1. Background

In 2019, with support from USAID’s Sustainable Financing for HIV project, VAAC estimated out-of-pocket expenditure (OOPE), inpatient care utilization, and total expenditures among patients on antiretroviral therapy (ART). The study showed that the transition from donor-financed to SHI-financed ART did not cause financial hardship for ART patients. Since 2021, a large number of ART patients (90%) have changed to the new ARV regimens (TLD and TLE 400), which were procured through the price negotiation method. Copayment subsidies for ARVs procured through this method are not clearly stipulated in current legal frameworks compared with ARVs procured through open bidding, for which subsidies are clearly outlined in legal documents.  

LHSS will work with VAAC to conduct a follow-up OOPE assessment among patients on SHI ART at public treatment facilities. The assessment results will be combined with those from the OOPE assessment to be conducted by the USAID/STEPS project at private treatment facilities to update the current OOPE estimation to better reflect Vietnam’s current context, including the inequitable subsidization of ARV copayments between ARVs procured by price-negotiation and open bidding.  In addition, many ART patients use multi-month dispensing (MMD), which may affect patients’ OOPE when they incur the SHI copayment cost. An increased number of PLHIV are also receiving viral load tests through SHI. LHSS will include these factors in the assessment, with a focus on determining copayment affordability and willingness to pay for extra services outside the current SHI benefit package. The aim is to generate evidence for the GVN and MOH to consider as they work to reduce OOPE and strengthen financial protection for PLHIV.

2.     Objectives and tasks of the assignment

2.1. Objective

The primary objective of the study is to estimate patients’ OOPE on HIV/AIDS prevention and treatment services, including ART, treatment of opportunistic infections, and testing services such as viral load testing. The results of this study are intended to inform ongoing efforts to track HIV/AIDS spending from all sources, both domestic and external sources, as well as provide evidence for the GVN’s and MOH’s consideration to reduce OOPE and strengthen financial protection for PLHIV.

It is noted that the USAID/STEPS project will conduct an OOPE assessment among PLHIV in private treatment facilities while LHSS will carry out the OOPE in the public sector. The LHSS team will work closely with USAID/STEPS to align assessment methodology and timeline to ensure data comparability and compilation between the two assessments, generating a comprehensive picture of OOPE among PLHIV.

2.2. Tasks

The consultant will work closely with VAAC and the LHSS project to oversee and coordinate the study, manage data collection efforts, provide data quality assurance, conduct data analysis, prepare reports, and provide overall logistical support, with main activities:

• Preparation of the research
• Piloting data collection instruments
• Data collection
• Data Analysis and Report-Writing

3.     DELIVERABLES

The consultant is expected to provide the following deliverables:

Activity	Deliverable(s)
Background/ Preparatory Work	Assessment protocol and estimated budget Data collection instruments in Vietnamese and English The electronic data collection tool matches the survey questionnaires.
Ethical approval from local and Abt IRB	Copy of local IRB and Abt approval or waiver letter.
Piloting data collection instruments	Pilot data collection report Revised data collection instruments based on the pilot
Data Collection	Raw assessment dataset with all the coded responses. The dataset should not contain any data or information that could be used to directly identify respondents to the survey separated for viral Load test and ART Short report (5 pages or less) on data collection processes All signed informed consent forms
Analysis and Report Writing	Data analysis plan with dummy tables Draft report with preliminary findings, including estimated OOPE for viral Load test and ART and willingness to pay for HIV services (10 to 20 pages excluding any data annexes) Draft PowerPoint presentation on preliminary assessment findings (10-15 slides)
	Final clean assessment dataset An excel table with result analysis in line with the data analysis plan Analysis syntax (codes) in Stata or SPSS and clean code book
	Draft report of OOPE and willingness to pay among PLHIV using SHI ART services and viral load testing services and evidence of the impact of copayments on PLHIV
	Final report and a policy brief of OOPE and willingness to pay among PLHIV using SHI ART services and viral load testing services and evidence of the impact of copayments on PLHIV (10 to 20 pages excluding any data annexes) Final PowerPoint presentation on OOPE assessment (15-20 slides)

4.     Requirements

• Graduate degree in Public Health or similar disciplines
• Excellent knowledge and understanding of HIV/AIDS care and treatment programs in Vietnam and its current context, especially at the decentralized level
• Strong understanding of SHI regulations in general and HIV/AIDS in particular
• Experience designing quantitative research studies, designing survey questionnaires, programming, and using electronic survey instruments, seeking IRB approval, conducting survey interviews, overseeing and training data collection teams, and ensuring data quality and data security.
• Experience using Stata or SPSS to analyze data.
• Demonstrated ability to work effectively with government agencies including VAAC, PAC, Provincial Department of Health, and health facilities providing HIV treatment. Experiences in providing consultancy services to USAID and PEPFAR partners
• Working knowledge of English.

5.     Submission timeline and contact point

The LHSS Vietnam project, funded by USAID and implemented by Abt Associates, will assist VAAC to conduct the assessment of the out-of-pocket expenditure and willingness to pay for PLHIV accessing SHI ART and viral load services in Vietnam. Thus, we are looking for a professional consultant specializing in survey/assessment implementation to do this job. Any professional consultant is interested in providing this service, please contact us at [email protected] to receive RFP. Deadline for submitting the technical and financial proposals: 30 Jan 2023

Organization: Abt Associates
Location:
Application deadline: 2023-01-30
Send application to: [email protected]